The value of patient and provider reported experiences in evaluating home-based assisted peritoneal dialysis

2017 
Rationale, aims and objectives: Assisted peritoneal dialysis (PD) is a proven intervention to support patients with functional limitations in performing home-based PD. Previous research has focused on clinical outcomes, but experiences with assisted PD have not been explored from the perspective of patients and providers. Through a 12-month pilot program called PD Assist (PDA) , this study elicited these perspectives to improve the program. Methods: A 12-month pilot of PDA delivered by a contracted health service provider delivered across multiple PD units in British Columbia, Canada, was evaluated. A multi-source evaluation model was used, including the semi-structured qualitative feedback in this report. Patients and their families, PD staff and caregiver stakeholders involved in the PDA pilot project, participated in the feedback process. Qualitative feedback was codified and analyzed via a thematic approach to identify values, enablers, barriers and suggestions for PDA program improvement from the perspective of patients and providers involved in PDA . Results: All stakeholder groups advocated for continuation of PDA services. Key reported values were patient independence, enhanced psychosocial support and relief of treatment-associated burden. Consistency and communication between involved parties were reported as enablers of success, while scheduling conflicts, geographic challenges and staffing inconsistency were viewed as barriers. Areas for program improvement included the need for more personalized services. Conclusions: Semi-structured qualitative feedback provided meaningful insights into the experiences of PDA among patients and providers that were an instrumental part of a successful pilot project and identified opportunities for further program improvement.
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