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ABSTRACT: Objectives
To describe the perspectives of clinicians and researchers on identifying, establishing and implementing core outcomes in haemodialysis and their expected impact.Design
Face-to-face, semistructured interviews; thematic analysis.Stetting
Twenty-seven centres across nine countries.Participants
Fifty-eight nephrologists (42 (72%) who were also triallists).Results
We identified six themes: reflecting direct patient relevance and impact (survival as the primary goal of dialysis, enabling well-being and functioning, severe consequences of comorbidities and complications, indicators of treatment success, universal relevance, stakeholder consensus); amenable and responsive to interventions (realistic and possible to intervene on, differentiating between treatments); reflective of economic burden on healthcare; feasibility of implementation (clarity and consistency in definition, easily measurable, requiring minimal resources, creating a cultural shift, aversion to intensifying bureaucracy, allowing justifiable exceptions); authoritative inducement and directive (endorsement for legitimacy, necessity of buy-in from dialysis providers, incentivising uptake); instituting patient-centredness (explicitly addressing patient-important outcomes, reciprocating trial participation, improving comparability of interventions for decision-making, driving quality improvement and compelling a focus on quality of life).Conclusions
Nephrologists emphasised that core outcomes should be relevant to patients, amenable to change, feasible to implement and supported by stakeholder organisations. They expected core outcomes would improve patient-centred care and outcomes.
SUBMITTER: Tong A
PROVIDER: S-EPMC5914778 | biostudies-literature | 2018 Apr
REPOSITORIES: biostudies-literature
Tong Allison A Crowe Sally S Gill John S JS Harris Tess T Hemmelgarn Brenda R BR Manns Braden B Pecoits-Filho Roberto R Tugwell Peter P van Biesen Wim W Wang Angela Yee Moon AYM Wheeler David C DC Winkelmayer Wolfgang C WC Gutman Talia T Ju Angela A O'Lone Emma E Sautenet Benedicte B Viecelli Andrea A Craig Jonathan C JC
BMJ open 20180420 4
<h4>Objectives</h4>To describe the perspectives of clinicians and researchers on identifying, establishing and implementing core outcomes in haemodialysis and their expected impact.<h4>Design</h4>Face-to-face, semistructured interviews; thematic analysis.<h4>Stetting</h4>Twenty-seven centres across nine countries.<h4>Participants</h4>Fifty-eight nephrologists (42 (72%) who were also triallists).<h4>Results</h4>We identified six themes: <i>reflecting direct patient relevance and impact</i> (survi ...[more]