Clinicians' and researchers' perspectives on establishing and implementing core outcomes in haemodialysis: semistructured interview study. Issue 4 (20th April 2018)

• Record Type: Journal Article
• Authors: Tong, Allison; Crowe, Sally; Gill, John S; Harris, Tess; Hemmelgarn, Brenda R; Manns, Braden; Pecoits-Filho, Roberto; Tugwell, Peter; van Biesen, Wim; Wang, Angela Yee Moon; Wheeler, David C; Winkelmayer, Wolfgang C; Gutman, Talia; Ju, Angela; O'Lone, Emma; Sautenet, Benedicte; Viecelli, Andrea; Craig, Jonathan C
• Is Part Of: BMJ open. Volume 8:Issue 4(2018)
• Publication Date: 2018-04-20
• Subjects: nephrology -- dialysis -- trials -- chronic renal failure; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2017-021198
• Languages: English
• ISSNs: 2044-6055

Abstract

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.