Hemodialysis Patient Preference for Type of Vascular Access: Variation and Predictors across Countries in the DOPPS

Purpose Catheters are associated with worse clinical outcomes than fistulas and grafts in hemodialysis (HD) patients. One potential modifier of patient vascular access (VA) use is patient preference for a particular VA type. The purpose of this study is to identify predictors of patient VA preferenc...

Full description

Saved in:
Bibliographic Details
Published in:The journal of vascular access 2013-07, Vol.14 (3), p.264-272
Main Authors: Fissell, Rachel B., Fuller, Douglas S., Morgenstern, Hal, Gillespie, Brenda W., Mendelssohn, David C., Rayner, Hugh C., Robinson, Bruce M., Schatell, Dori, Kawanishi, Hideki, Pisoni, Ronald L.
Format: Article
Language:English
Subjects:
Age Factors
Aged
Aged, 80 and over
Australia - epidemiology
Canada - epidemiology
Catheterization, Central Venous - adverse effects
Catheterization, Central Venous - instrumentation
Central Venous Catheters - adverse effects
Cross-Sectional Studies
Cultural Characteristics
Europe - epidemiology
Female
Health Care Surveys
Health Knowledge, Attitudes, Practice - ethnology
Healthcare Disparities - ethnology
Humans
Japan - epidemiology
Logistic Models
Male
Middle Aged
Multivariate Analysis
New Zealand - epidemiology
Odds Ratio
Patient Preference - ethnology
Practice Patterns, Physicians
Renal Dialysis
Sex Factors
United States - epidemiology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose Catheters are associated with worse clinical outcomes than fistulas and grafts in hemodialysis (HD) patients. One potential modifier of patient vascular access (VA) use is patient preference for a particular VA type. The purpose of this study is to identify predictors of patient VA preference that could be used to improve patient care. Methods This study uses a cross-sectional sample of data from the Dialysis Outcomes and Practice Patterns Study (DOPPS 3, 2005-09), that includes 3815 HD patients from 224 facilities in 12 countries. Using multivariable models we measured associations between patient demographic and clinical characteristics, previous catheter use and patient preference for a catheter. Results Patient preference for a catheter varied across countries, ranging from 1% of HD patients in Japan and 18% in the United States, to 42% to 44% in Belgium and Canada. Preference for a catheter was positively associated with age (adjusted odds ratio per 10 years=1.14; 95% 0=1.02-1.26), female sex (OR 1.49; 95% 0=1.15-1.93), and former (OR=2.61; 95% 0=1.66-4.12) or current catheter use (OR=60.3; 95% 0=36.5-99.8); catheter preference was inversely associated with time on dialysis (OR per three years=0.90; 95% 0=0.82-0.97). Conclusions Considerable variation in patient VA preference was observed across countries, suggesting that patient VA preference may be influenced by sociocultural factors and thus could be modifiable. Catheter preference was greatest among current and former catheter users, suggesting that one way to influence patient VA preference may be to avoid catheter use whenever possible.
ISSN:1129-7298
1724-6032
DOI:10.5301/jva.5000140