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Construction of the ESKD Life Plan

ESKD 生命计划的构建

基本信息

批准号：
10353406
负责人：
Karen Woo
金额：
$ 11.7万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-03-01 至 2024-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10353406
关键词：
Address Adoption Affect Area Arteriovenous fistula Attitude Blood Vessels Caring Case Management Clinical Clinical Practice Guideline Collaborations Complication Conflict (Psychology)Data Decision Making Development Dialysis procedure Educational Materials End stage renal failure Face Failure Feeling Fistula Foundations Funding Future Goals Grant Guidelines Healthcare Systems Hemodialysis Hospitalization Individual Infrastructure Interdisciplinary Study Interview Kidney Knowledge Life Longevity Malignant Neoplasms Medical Medicare Methods Modeling Nature Outcome Participant Patient Preferences Patient Rights Patients Peer Review Physicians Population Procedures Process Provider Quality of Care Quality of life Recommendation Renal function Research Source Specific qualifier value Structure Surgeon Testing Time Training Update Vascular Graft Vision care providers experience field study individual patient medical specialties multidisciplinary novel operation patient engagement patient oriented preference prototype radiologist shared decision making tool

项目摘要

PROJECT SUMMARY/ABSTRACT Decisions about vascular access in patients with end-stage kidney disease (ESKD) who are hemodialysis dependent can strongly influence clinical outcomes of vascular access longevity, need for revision procedures, repeat access operations and hospitalizations which in turn affect patients' quality of life. Addressing this, the pending update of the National Kidney Foundation Dialysis Outcomes Quality Initiative (K-DOQI) Clinical Practice Guideline for Vascular Access recommends construction and regular update of an individualized ESKD Life-Plan for each patient. Such vascular access Life-Plans encompass a specific plan for all of the vascular accesses for an individual patient for the remainder of the patient’s hemodialysis-dependent life. Life- Plans are to be developed by the provider team in conjunction with the patient, within a multidisciplinary team framework. However, implementing K-DOQI-recommended Life-Plans can require considerable infrastructure and may face significant barriers, as the concept of such an ESKD Life-Plan is entirely novel both to patients and providers. The goal of the proposed research is to ascertain providers', patients' and relevant stakeholders’ attitudes and preferences for how the multidisciplinary provider-patient discussions should be conducted. To overcome barriers to implementing K-DOQI guidelines, relevant patients and providers will be engaged in co- developing a toolkit for ESKD Life-Plan implementation focused on patient engagement, shared decision-making and barriers and facilitators to multidisciplinary collaboration. First, qualitative individual semi-structured interviews with approximately 55 patients and providers will be used, enabling a) unrestricted exploration of the topic; and b) participants to express attitudes and preferences in their own words. These data will then be used to develop a prototype Life-Plan implementation toolkit that accommodates diverse patient preferences and healthcare systems, and perform its initial field testing and peer review. This will inform future grant-funded implementation testing to determine the toolkit's efficacy and utility in enabling and facilitating transition to the new vascular access paradigm. The Specific Aims are to: 1: Determine the attitudes and preferences of relevant patients and providers with respect to degree and nature of their own involvement in shared decision-making and development of the ESKD Life-Plan. 2: Develop and perform initial field testing and peer review of a Life-Plan implementation toolkit that empowers patients to engage in the vascular access shared decision-making process and offers methods to providers to overcome challenges of the multidisciplinary team approach.

项目总结/摘要终末期肾病（ESKD）血液透析患者血管通路的决定依赖性可强烈影响血管通路寿命的临床结局，是否需要翻修手术，重复手术和住院，这反过来又影响了患者的生活质量。针对这一点，国家肾脏基金会透析结果质量倡议（K-DOQI）临床血管通路实践指南建议构建和定期更新个性化的每位患者的ESKD生命计划。这样的血管通路生命计划包括针对所有患者的特定计划。在患者的血液透析依赖性生命的剩余时间内为个体患者提供血管通路。生活- 计划将由提供者团队与患者一起在多学科团队中制定框架.然而，实施K-DOQI推荐的生命计划可能需要大量的基础设施并且可能面临重大障碍，因为这种ESKD生命计划的概念对患者和患者都是全新的，和供应商。拟议研究的目标是确定提供者，患者和相关的利益相关者的态度和偏好的多学科提供者-患者的讨论应该是进行。为了克服实施K-DOQI指南的障碍，相关患者和提供者将共同参与，开发ESKD生命计划实施工具包，重点关注患者参与、共同决策以及多学科合作的障碍和促进因素。第一，定性个体半结构化将使用约55名患者和提供者的访谈，使a）不受限制地探索主题;以及B）参与者用自己的话表达态度和偏好。这些数据将用于开发一个原型生命计划实施工具包，以适应不同的患者偏好，医疗保健系统，并进行初步的实地测试和同行评审。这将为未来的赠款供资提供信息。执行情况测试，以确定工具包在促成和促进向新的血管通路范例。具体目标是： 1：确定相关患者和医疗服务提供者对程度和他们自己参与共同决策和制定ESKD生活计划的性质。 2：制定和执行初步的实地测试和同行审查的生命计划执行工具包，患者参与血管通路共享决策过程，并为供应商提供方法，克服多学科团队方法的挑战。

项目成果

期刊论文数量（4）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Barriers to Implementing the Kidney Disease Outcomes Quality Initiative End-Stage Kidney Disease Life Plan Guideline.

DOI：
10.1007/s11606-023-08290-5
发表时间：
2023-11
期刊：
JOURNAL OF GENERAL INTERNAL MEDICINE
影响因子：
5.7
作者：
Keller, Michelle S.;Mavilian, Christine;Altom, Keaton L.;Erickson, Kevin F.;Drudi, Laura M.;Woo, Karen
通讯作者：
Woo, Karen

Thrombus Extension after Great Saphenous Vein Mechanochemical Ablation.