ArticleBMC health services research2021
Information about different treatment options and shared decision making in dialysis care - a retrospective survey among hemodialysis patients.
Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Shared Decision-Making in Dialysis Modality Selection Among Adults with Advanced Kidney Disease in Saudi Arabia: A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2026Article
- Shared decision-making for kidney replacement therapy: a comprehensive review and a proposed model.The Korean journal of internal medicine · 2025Review
- Shared Decision-Making in Choosing Dialysis Modalities for Patients With Chronic Kidney Disease: An Evolutionary Concept Analysis.Nursing & health sciences · 2025Review
- Communicating treatment options to older patients with advanced kidney disease: a conversation analysis study.BMC nephrology · 2024Observational
- The Lack of a Standardized Definition of Chronic Dialysis Treatment in German Statutory Health Insurance Claims Data—Effects on Estimated Incidence and Mortality.Deutsches Arzteblatt international · 2024Observational
- Article
- Exploring the Key Factors of Shared Decision-Making Through an Influential Network Relation Map: The Orthopedic Nurse's Perspective.Frontiers in medicine · 2021Article
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Authors and funding
4 authors.
Funding
Abstract
backgroundHemodialysis (HD) and peritoneal dialysis (PD) are equivalent treatment alternatives for patients with end stage renal disease. In Germany, there is a legal obligation to inform every patient about all treatment alternatives and their possible harms and benefits. However, there is a low utilization of PD. Therefore, the question arises, whether HD patients perceive that they were informed about different dialysis options. We further investigate, if personal characteristics of informed and non-informed patients vary, and if both groups experienced the decision for their dialysis treatment as shared decision making (SDM).
methodsThe database was a nationwide postal survey of 590 HD patients from two statutory health insurers in Germany. Participants were asked whether they have been informed about both dialysis options. A logistic regression model examines impact factors on this information. We investigate differences in the German version of the 9-item SDM Questionnaire (SDM-Q-9) between informed and non-informed patients with a multivariate linear regression model.
results56 % of the respondents reported they had been informed about different dialysis treatment options. Patients older than 65 had a 61 % lower chance than patients ≤ 65 for this information (p < 0.001). High educated patients had a 47 % higher chance for this information than patients with low education level (p = 0.030). Informed patients rated a higher SDM-Q-9 scores than non-informed patients (76.9 vs. 44.2; p < 0.001). Non-informed patients showed high values in those SDM-Q-9 items which had no regard to different treatment options.
conclusionsA great proportion of HD patients - mostly elderly patients and patients with a low education level - did not perceive that they were informed about different dialysis options before dialysis was initiated. The current obligation to provide information about all treatment alternatives in Germany is a first step to assure the unselected access to different treatment options. But it has not reached routine application in health care yet. Information about different treatment options can pave the way for SDM. While SDM is considered to be a valuable tool in clinical medicine, there is still room for improvement for its successful implementation when it comes to decision making on different dialysis treatment options.
trial registrationThe MAU-PD study (Multidimensional analysis of causes for the low prevalence of ambulatory peritoneal dialysis in Germany) is registered at the German Clinical Trials Register. DRKS-ID: DRKS00012555 Link: https://www.drks.de/drks_web/setLocale_EN.do . Date of Registration in DRKS: 2018/01/04.
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