Shared decision-making in hemodialysis vascular access practice.
arteriovenous fistula
arteriovenous graft
hemodialysis
shared decision
vascular access
Journal
Kidney international
ISSN: 1523-1755
Titre abrégé: Kidney Int
Pays: United States
ID NLM: 0323470
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
23
02
2021
revised:
24
05
2021
accepted:
28
05
2021
pubmed:
12
7
2021
medline:
21
10
2021
entrez:
11
7
2021
Statut:
ppublish
Résumé
Shared decision-making (SDM) is a process of collaborative deliberation in the dyadic patient-physician interaction whereby physicians inform the patients about the pros and cons of all available treatment options and reach an agreement with the patients on their preferred treatment plan. In hemodialysis vascular access practice, SDM advocates a deliberative approach based on the existence of reasonable alternatives-that is, arteriovenous fistula, arteriovenous graft, and central venous catheter-so that patients are able to form and share preferences about access options. In spite of its ethical imperative, SDM is not broadly applied in hemodialysis vascular access planning. Physicians and surgeons commonly deliver prescriptive fistula-centered recommendations concerning the approach to vascular access care. This paternalistic approach has been shaped by directions from long-held clinical practice guidelines and is reinforced by financial payment models linked with the prevalence of arteriovenous fistula in patients on hemodialysis. Awareness is growing that what may have initially seemed a medically and surgically appropriate approach might not always be focused on each individual's goals of care. Clinician's recommendations for vascular access often do not sufficiently consider the uncertainty surrounding the potential benefits of the decision or the cumulative impact of the decision on patient's quality of life. In the evolving health care landscape, it is time for the practice of hemodialysis vascular access to shift from a hierarchical doctor-patient approach to patient-centered care. In this article we review the current state of vascular access practice, present arguments why SDM is necessary in vascular access planning, review barriers and potential solutions to SDM implementation, and discuss future research contingent on an effective system of physician-patient participative decision-making in hemodialysis vascular access practice.
Identifiants
pubmed: 34246655
pii: S0085-2538(21)00668-2
doi: 10.1016/j.kint.2021.05.041
pmc: PMC8463450
mid: NIHMS1722574
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
799-808Subventions
Organisme : NIA NIH HHS
ID : R01 AG071803
Pays : United States
Organisme : NIMHD NIH HHS
ID : R01 MD013818
Pays : United States
Organisme : NIA NIH HHS
ID : R03 AG060178
Pays : United States
Informations de copyright
Copyright © 2021 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.
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