Innovation and Collaboration Key Ingredients to Transitioning Patients Requiring Dialysis from Hospital to the Comfort of their own Homes

Home dialysis provides patients with more control and personal flexibility, while helping reduce costs to the healthcare system

TORONTO, March 4, 2014 /CNW/ - Approximately 2.6 million Canadians have kidney disease or are at risk and the rate is growing.¹ This statistic, coupled with the desire to better serve patients' needs, have prompted some Ontario hospitals to find innovative solutions to help more chronic kidney disease (CKD) patients requiring dialysis to receive it at home, resulting in increased quality of life for patients^2,3,4,5 and overall savings to the healthcare system.⁶

Many CKD patients are eligible to receive dialysis at home and when given the choice, research shows that 50 per cent of pre-dialysis patients would prefer to be treated at home⁷  However, research also suggests that across Canada on average only 17 per cent of patients are receiving peritoneal dialysis - a home-based alternative to clinic-based hemodialysis treatment.⁸

Baxter Corporation, a global leader in the treatment of CKD and sponsor of World Kidney Day 2014, led the development of peritoneal dialysis 35 years ago in partnership with nephrologists at Toronto General Hospital. 

"Baxter recently marked the 35^th anniversary of home dialysis and we applaud the important strides being made by hospitals to meet patients' needs," comments Victoria Jurincic, General Manager of Baxter-Gambro Canada, renal division of Baxter Corporation.  "Baxter is proud to support World Kidney Day and to join the global kidney disease community in urging those at risk to get screened and learn about their therapy options. We are dedicated to helping chronic kidney disease patients live well and to working with the community to ensure patients receive the right care, in the right setting, at the right time."

Finding solutions to meet the influx of patients requiring dialysis is a priority for the Ontario government which in 2009 launched the Ontario Renal Network (ORN) to lead and manage CKD care in concert with hospitals across the province. A key focus is to ensure that 40 per cent of all new dialysis patients will be on an independent or home dialysis option within six months of initiating dialysis.

"Our government is a strong supporter of ensuring patients have access to the care they need, as close to home as possible," said Deb Matthews, Ontario's Minister of Health and Long Term Care. "We have seen considerable increases in the number of patients receiving in-home dialysis treatment over the years and continue to invest considerably in community supports to help keep Ontarians healthy and in their homes, amongst family and friends."

Rising to this occasion, Ontario hospitals such as William Osler Health System and St Joseph's Healthcare Hamilton have been spearheading new innovative approaches that are successfully helping more patients to be treated at home.

Sharing best practices:  St. Joseph's Healthcare Hamilton

St. Joseph's Healthcare Hamilton has a Strategic Plan which is aligned with the provincial initiatives of the Ontario Renal Network and designed to increase the number of patients using home-based hemodialysis or peritoneal dialysis methods. Over the past year, St. Joseph's Healthcare Hamilton has seen its home dialysis program grow by approximately 25 per cent.

"Our program begins and ends with the patients," says Dr. Darin Treleaven, head of St. Joseph's Healthcare Hamilton Nephrology Program.  "We should be providing patients with choices and structure that facilitates having as normal life as possible."

While studies reveal that many patients who currently dialyze in acute care hospital settings are eligible for personal home-based or peritoneal dialysis systems, those same patients may lack the confidence and knowledge required to play such a leadership role in the management of their disease.

At St. Joseph's Healthcare Hamilton, successful treatment with home-based dialysis depends in great degree on: good staff training and collaboration; hospital buy-in on the goals and benefits of the program from the top down; nurses acting as patient navigators throughout the process; finding innovative solutions to ensure timely tube / catheter insertions for more patients; as well as efficient and early education of patients and their caregivers, and collaboration with local CCACs to ensure patients have enough support while at home.

"From the hospital board to the clinic staff, everyone at St. Joseph's has demonstrated their commitment to the cause.  Once the clinical benefits were realized, it was natural to make it a strategic imperative - this ensured the whole organization, from the senior team down, made it a priority by sharing expertise and knowledge for the further benefit of our patients," notes Rick Badzioch, clinical director of St. Joseph's Healthcare Hamilton Nephrology Program.

Sharing best practices:  William Osler Health System

William Osler Health System's (Osler) success - 55 per cent growth in the past year alone - is primarily due to early one-on-one education between the patient and a nurse, as patients arrive at the hospital, and having a skilled surgeon and space dedicated one day per month to peritoneal dialysis catheter insertion. Osler also does a joint visit with their nurse and the local CCAC as a way of transitioning the home dialysis patient from hospital to community.

"Very few patients with proper supports in place would be inappropriate for peritoneal dialysis," says Dr. Hitesh Mehta, Nephrologist, William Osler Health System.  "Research supports that the vast majority of patients can do it, yet outdated thinking prevents this.   To move patients to peritoneal dialysis or home-based care, support must be in place - beginning with patient educators who are experienced in home dialysis and dedicated surgeons and procedure space for catheter insertions. Hospitals are for the sick, and therefore where it is possible, in centre dialysis should be restricted to those who need to be there."

About Baxter Corporation 

As a subsidiary of Baxter International Inc., Baxter Corporation manufactures and markets products that save and sustain the lives of people with hemophilia, immune disorders, infectious diseases, kidney disease, trauma and other chronic and acute medical conditions. As a global, diversified healthcare company, Baxter applies a unique combination of expertise in medical devices, pharmaceuticals and biotechnology to create products that advance patient care worldwide.

Baxter aims to offer patients the right therapy, at the right time, in the right setting, and believes in making the optimal therapeutic modality possible for more patients. As a global leader in renal replacement therapies, Baxter is committed to providing an innovative portfolio of products to deliver the highest quality outcomes.  With the recent acquisition of Gambro, the company now serves renal patient needs from the hospital to the home with a comprehensive portfolio of therapies and supplies for peritoneal dialysis (PD), in-center hemodialysis (HD), home hemodialysis (HHD), extracorporeal therapies and additional dialysis services.

Baxter has been a dialysis pioneer for more than 50 years, beginning with the introduction of the first commercially built artificial kidney. In 1978, Baxter worked with Canadian nephrologists to develop PD as the world's first portable home dialysis therapy which is now used daily by thousands of patients worldwide to help save and sustain their lives.  Today, Baxter continues to innovate home therapy options aimed at providing enhanced clinical outcomes and quality of life for patients.  To learn more about Baxter, visit www.baxter.ca.

References

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¹ Kidney Foundation of Canada, FACING THE FACTS, http://www.kidney.ca/document.doc?id=1376
² Tong, A. et al. The Perspectives of Adults Living With Peritoneal Dialysis: Thematic Synthesis of Qualitative Studies.  Am J Kidney Dis. 2013;61(6):873-888.
³ Kutner NG, Zhang R, Barnhart H, Collins AJ. Health status and quality of life reported by incident patients after 1 year on haemodialysis or peritoneal dialysis. Nephrol Dial Transplant. 2005;20:2159-2167.
⁴ Frimat L, Durand PY, Loos-Ayav C, et al. Impact of first dialysis modality on outcome of patients contraindicated for kidney transplant. Perit Dial Int. 2006;26:231-239.
⁵ Molsted S, Prescott L, Heaf J, Eidemak I. Assessment and clinical aspects of health-related quality of life in dialysis patients and patients with chronic kidney disease. Nephron Clin Pract. 2007;106:c24-c33.
⁶ Cleemput I et al. Organisation et financement de la dialyse chronique en Belgique. Health Technology Assessment (HTA). Bruxelles. KCE 2010.
⁷ Goovaert T, Jadoul M, Goffin E. Influence of a pre-dialysis education programme (PDEP) on the mode of renal replacement therapy. Nephrol Dial Transplant 2005; 20:1842-1847.
⁸ Canadian Institute for Health Information. Canadian Organ Replacement Register Annual Report: Treatment of End-Stage Organ Failure in Canada, 2002 to 2011.
Available at: https://secure.cihi.ca/free_products/2013_CORR_Annua_Report_EN.pdf.

SOURCE: Baxter Corporation

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Shaday Livingston
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Heather MacDonnell
Baxter Corporation
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