The way home: a scoping review of public health interventions to increase the utilization of home dialysis in chronic kidney disease patients

Abstract Background Home dialysis (HoD) remains underutilized, despite evidence showing it provides comparable mortality rates to in-center hemodialysis (ICHD) while offering advantages such as improved quality of life and lower overall costs. This scoping review comprehensively evaluates the effect...

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Main Authors: Natcha Yongphiphatwong, Yot Teerawattananon, Pitsinee Supapol, Denla Pandejpong, Tanainan Chuanchaiyakul, Jiratorn Sutawong, Naline Gandhi, Nutthawongse Kiatkrissada, Saudamini Vishwanath Dabak, Thunyarat Anothaisintawee
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Nephrology
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Online Access:https://doi.org/10.1186/s12882-025-04072-9
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author Natcha Yongphiphatwong
Yot Teerawattananon
Pitsinee Supapol
Denla Pandejpong
Tanainan Chuanchaiyakul
Jiratorn Sutawong
Naline Gandhi
Nutthawongse Kiatkrissada
Saudamini Vishwanath Dabak
Thunyarat Anothaisintawee
author_facet Natcha Yongphiphatwong
Yot Teerawattananon
Pitsinee Supapol
Denla Pandejpong
Tanainan Chuanchaiyakul
Jiratorn Sutawong
Naline Gandhi
Nutthawongse Kiatkrissada
Saudamini Vishwanath Dabak
Thunyarat Anothaisintawee
author_sort Natcha Yongphiphatwong
collection DOAJ
description Abstract Background Home dialysis (HoD) remains underutilized, despite evidence showing it provides comparable mortality rates to in-center hemodialysis (ICHD) while offering advantages such as improved quality of life and lower overall costs. This scoping review comprehensively evaluates the effects of public health interventions on the uptake and retention of HoD utilization, including both Peritoneal Dialysis (PD) and Home Hemodialysis (HHD). Methods Relevant studies were searched in the Web of Science, Medline, Embase, Scopus, EBSCOhost, and EconLit databases from their inception through May 2024. Studies were eligible for review if they assessed the effectiveness of public health interventions in terms of utilization and retention rates for general HoD, PD, and HHD. Results Forty-three studies were included, with interventions categorized into three main types: educational programs, service provision improvements, and modifications to payment structures. Our findings indicate that educational interventions—aimed at enhancing knowledge about dialysis options and promoting shared decision-making among patients, families, and healthcare providers—and service provision improvements, such as assisted PD and nephrologist-performed catheter insertions, could significantly increase the initiation, utilization, and retention rates of HoD. However, the impact of payment interventions on HoD outcomes differed across different contexts. Conclusion Education and service provision enhancements may represent the most effective public health interventions for increasing initiation, utilization, and retention rates of HoD in dialysis-requiring patients. However, these findings are predominantly based on evidence from observational studies; further experimental studies with rigorous methodology are warranted to validate the effectiveness of these interventions in promoting HoD utilization.
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spelling doaj-art-d9ab94829ab6460ea7fdc2fe81b098a32025-08-20T03:08:05ZengBMCBMC Nephrology1471-23692025-04-0126111610.1186/s12882-025-04072-9The way home: a scoping review of public health interventions to increase the utilization of home dialysis in chronic kidney disease patientsNatcha Yongphiphatwong0Yot Teerawattananon1Pitsinee Supapol2Denla Pandejpong3Tanainan Chuanchaiyakul4Jiratorn Sutawong5Naline Gandhi6Nutthawongse Kiatkrissada7Saudamini Vishwanath Dabak8Thunyarat Anothaisintawee9Thailand Development Research Institute (TDRI)Health Intervention and Technology Assessment Program (HITAP), Ministry of Public HealthHealth Intervention and Technology Assessment Program (HITAP), Ministry of Public HealthHealth Intervention and Technology Assessment Program (HITAP), Ministry of Public HealthHealth Intervention and Technology Assessment Program (HITAP), Ministry of Public HealthHealth Intervention and Technology Assessment Program (HITAP), Ministry of Public HealthDUKE-NUS Medical SchoolFaculty of Pharmaceutical Science, Chulalongkorn UniversityHealth Intervention and Technology Assessment Program (HITAP), Ministry of Public HealthDepartment of Clinical Epidemiology and Biostatistics, Department of Family Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol UniversityAbstract Background Home dialysis (HoD) remains underutilized, despite evidence showing it provides comparable mortality rates to in-center hemodialysis (ICHD) while offering advantages such as improved quality of life and lower overall costs. This scoping review comprehensively evaluates the effects of public health interventions on the uptake and retention of HoD utilization, including both Peritoneal Dialysis (PD) and Home Hemodialysis (HHD). Methods Relevant studies were searched in the Web of Science, Medline, Embase, Scopus, EBSCOhost, and EconLit databases from their inception through May 2024. Studies were eligible for review if they assessed the effectiveness of public health interventions in terms of utilization and retention rates for general HoD, PD, and HHD. Results Forty-three studies were included, with interventions categorized into three main types: educational programs, service provision improvements, and modifications to payment structures. Our findings indicate that educational interventions—aimed at enhancing knowledge about dialysis options and promoting shared decision-making among patients, families, and healthcare providers—and service provision improvements, such as assisted PD and nephrologist-performed catheter insertions, could significantly increase the initiation, utilization, and retention rates of HoD. However, the impact of payment interventions on HoD outcomes differed across different contexts. Conclusion Education and service provision enhancements may represent the most effective public health interventions for increasing initiation, utilization, and retention rates of HoD in dialysis-requiring patients. However, these findings are predominantly based on evidence from observational studies; further experimental studies with rigorous methodology are warranted to validate the effectiveness of these interventions in promoting HoD utilization.https://doi.org/10.1186/s12882-025-04072-9Home dialysisChronic kidney diseasePolicy interventionsSystematic review
spellingShingle Natcha Yongphiphatwong
Yot Teerawattananon
Pitsinee Supapol
Denla Pandejpong
Tanainan Chuanchaiyakul
Jiratorn Sutawong
Naline Gandhi
Nutthawongse Kiatkrissada
Saudamini Vishwanath Dabak
Thunyarat Anothaisintawee
The way home: a scoping review of public health interventions to increase the utilization of home dialysis in chronic kidney disease patients
BMC Nephrology
Home dialysis
Chronic kidney disease
Policy interventions
Systematic review
title The way home: a scoping review of public health interventions to increase the utilization of home dialysis in chronic kidney disease patients
title_full The way home: a scoping review of public health interventions to increase the utilization of home dialysis in chronic kidney disease patients
title_fullStr The way home: a scoping review of public health interventions to increase the utilization of home dialysis in chronic kidney disease patients
title_full_unstemmed The way home: a scoping review of public health interventions to increase the utilization of home dialysis in chronic kidney disease patients
title_short The way home: a scoping review of public health interventions to increase the utilization of home dialysis in chronic kidney disease patients
title_sort way home a scoping review of public health interventions to increase the utilization of home dialysis in chronic kidney disease patients
topic Home dialysis
Chronic kidney disease
Policy interventions
Systematic review
url https://doi.org/10.1186/s12882-025-04072-9
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