Effects of Educational Practices on the Peritonitis Risk in Peritoneal Dialysis: a Retrospective Cohort Study with Data from the French Peritoneal Dialysis Registry (RDPLF)

Overview

Journal BMC Nephrol

Publisher Biomed Central

Specialty Nephrology

Date 2020 May 31

PMID 32471380

Citations 4

Authors

Helene Bonnal

Clemence Bechade

Annabel Boyer

Thierry Lobbedez

Sonia Guillouet

Christian Verger

Maxence Ficheux

Antoine Lanot

Affiliations

Soon will be listed here.

Abstract

Background: Peritoneal dialysis (PD) is a home-based therapy performed by patients or their relatives in numerous cases, and the role of patients' educational practices in the risk of peritonitis is not well assessed. Our aim was to evaluate the effect of PD learning methods on the risk of peritonitis.

Methods: This was a retrospective multicentric study based on data from a French registry. All incident adults assisted by family or autonomous for PD exchanges in France between 2012 and 2015 were included. The event of interest was the occurrence of peritonitis. Cox and hurdle regression models were used for statistical analysis to asses for the survival free of peritonitis, and the risk of first and subsequent peritonitis.

Results: 1035 patients were included. 967 (93%) received education from a specialized nurse. Written support was used for the PD learning in 907 (87%) patients, audio support in 221 (21%) patients, and an evaluation grid was used to assess the comprehension in 625 (60%) patients. In the "zero" part of the hurdle model, the use of a written support and starting PD learning with hands-on training alone were associated with a lower survival free of peritonitis (respectively HR 1.59, 95%CI 1.01-2.5 and HR 1.94, 95%CI 1.08-3.49), whereas in the "count" part, the use of an audio support and starting of PD learning with hands-on training in combination with theory were associated with a lower risk of presenting further episodes of peritonitis after a first episode (respectively HR 0.55, 95%CI 0.31-0.98 and HR 0.57, 95%CI 0.33-0.96).

Conclusions: The various PD education modalities were associated with differences in the risk of peritonitis. Prospective randomized trials are necessary to confirm causal effect. Caregivers should assess the patient's preferred learning style and their literacy level and adjust the PD learning method to each individual.

Citing Articles

Effectiveness of a Customized Peritoneal Dialysis Training Program in Reducing Infection and Dropout Rates: Insights From a Singapore Hospital.

Lee P, Tay H, Luo X, Chiang S, Loh S, Lai B Cureus. 2024; 16(8):e67997.

PMID: 39347122 PMC: 11437699. DOI: 10.7759/cureus.67997.

Patient education interventions for haemodialysis and peritoneal dialysis catheter care: An integrative review.

Leong F, Binte Abu Bakar Aloweni F, Choo J, Lim S Int J Nurs Stud Adv. 2024; 5:100156.

PMID: 38746579 PMC: 11080360. DOI: 10.1016/j.ijnsa.2023.100156.

Simulation-based learning in nephrology.

Maisons V, Lanot A, Luque Y, Sautenet B, Esteve E, Guillouet E Clin Kidney J. 2024; 17(4):sfae059.

PMID: 38680455 PMC: 11053359. DOI: 10.1093/ckj/sfae059.

A Cross-sectional Study of Fixed and Growth Mindset in Adult Peritoneal Dialysis Patients.

Fissell R, Schlundt D, Cavanaugh K, Mueller C, Umeukeje E, Nair D J Patient Exp. 2021; 8:23743735211055289.

PMID: 34820508 PMC: 8606950. DOI: 10.1177/23743735211055289.

References

Morony S, Flynn M, McCaffery K, Jansen J, Webster A . Readability of Written Materials for CKD Patients: A Systematic Review. Am J Kidney Dis. 2015; 65(6):842-50. DOI: 10.1053/j.ajkd.2014.11.025. View

Ghali J, Bannister K, Brown F, Rosman J, Wiggins K, Johnson D . Microbiology and outcomes of peritonitis in Australian peritoneal dialysis patients. Perit Dial Int. 2011; 31(6):651-62. DOI: 10.3747/pdi.2010.00131. View

Boudville N, Cho Y, Equinox K, Figueiredo A, Hawley C, Howard K . Teaching peritoneal dialysis in Australia: An opportunity for improvement. Nephrology (Carlton). 2017; 23(3):259-263. DOI: 10.1111/nep.12992. View

Fried L, Abidi S, Bernardini J, JOHNSTON J, Piraino B . Hospitalization in peritoneal dialysis patients. Am J Kidney Dis. 1999; 33(5):927-33. DOI: 10.1016/s0272-6386(99)70428-2. View

Liberek T, Renke M, Skonieczny B, Kotewicz K, Kowalewska J, Chmielewski M . Therapy outcome in peritoneal dialysis patients transferred from haemodialysis. Nephrol Dial Transplant. 2009; 24(9):2889-94. DOI: 10.1093/ndt/gfp132. View

Martin L, Caramori J, Fernandes N, Divino-Filho J, Pecoits-Filho R, Barretti P . Geographic and educational factors and risk of the first peritonitis episode in Brazilian Peritoneal Dialysis study (BRAZPD) patients. Clin J Am Soc Nephrol. 2011; 6(8):1944-51. PMC: 3359536. DOI: 10.2215/CJN.11431210. View

Lex A, Gehlenborg N, Strobelt H, Vuillemot R, Pfister H . UpSet: Visualization of Intersecting Sets. IEEE Trans Vis Comput Graph. 2015; 20(12):1983-92. PMC: 4720993. DOI: 10.1109/TVCG.2014.2346248. View

Figueiredo A, Bernardini J, Bowes E, Hiramatsu M, Price V, Su C . A Syllabus for Teaching Peritoneal Dialysis to Patients and Caregivers. Perit Dial Int. 2016; 36(6):592-605. PMC: 5174866. DOI: 10.3747/pdi.2015.00277. View

Piraino B, Bernardini J, Brown E, Figueiredo A, Johnson D, Lye W . ISPD position statement on reducing the risks of peritoneal dialysis-related infections. Perit Dial Int. 2011; 31(6):614-30. DOI: 10.3747/pdi.2011.00057. View

10.

Figueiredo A, Moraes T, Bernardini J, Poli-de-Figueiredo C, Barretti P, Olandoski M . Impact of patient training patterns on peritonitis rates in a large national cohort study. Nephrol Dial Transplant. 2014; 30(1):137-42. DOI: 10.1093/ndt/gfu286. View

11.

Obi Y, Streja E, Mehrotra R, Rivara M, Rhee C, Soohoo M . Impact of Obesity on Modality Longevity, Residual Kidney Function, Peritonitis, and Survival Among Incident Peritoneal Dialysis Patients. Am J Kidney Dis. 2017; 71(6):802-813. PMC: 5970950. DOI: 10.1053/j.ajkd.2017.09.010. View

12.

Lachenbruch P . Comparisons of two-part models with competitors. Stat Med. 2001; 20(8):1215-34. DOI: 10.1002/sim.790. View

13.

Hsu C, Lee C, Chen Y, Ting M, Sun C, Chen C . Multidisciplinary predialysis education reduces incidence of peritonitis and subsequent death in peritoneal dialysis patients: 5-year cohort study. PLoS One. 2018; 13(8):e0202781. PMC: 6107258. DOI: 10.1371/journal.pone.0202781. View

14.

Kim H, Lee J, Park M, Kim Y, Lee H, Kim D . Lower Education Level Is a Risk Factor for Peritonitis and Technique Failure but Not a Risk for Overall Mortality in Peritoneal Dialysis under Comprehensive Training System. PLoS One. 2017; 12(1):e0169063. PMC: 5215932. DOI: 10.1371/journal.pone.0169063. View

15.

Guilloteau S, Lobbedez T, Guillouet S, Verger C, Ficheux M, Lanot A . Impact of Assisted Peritoneal Dialysis Modality on Outcomes: A Cohort Study of the French Language Peritoneal Dialysis Registry. Am J Nephrol. 2018; 48(6):425-433. DOI: 10.1159/000494664. View

16.

Chow J, Cho Y, Equinox K, Figueiredo A, Frasca S, Hawley C . An Intervention Design: Supporting Skills Development for Peritoneal Dialysis Trainers. Perit Dial Int. 2019; 39(2):134-141. DOI: 10.3747/pdi.2018.00159. View

17.

Wiggins K, Craig J, Johnson D, Strippoli G . Treatment for peritoneal dialysis-associated peritonitis. Cochrane Database Syst Rev. 2008; (1):CD005284. DOI: 10.1002/14651858.CD005284.pub2. View

18.

Benain J, Faller B, Briat C, Jacquelinet C, Brami M, Aoustin M . [Cost of dialysis in France]. Nephrol Ther. 2007; 3(3):96-106. DOI: 10.1016/j.nephro.2007.03.001. View

19.

Chern Y, Ho P, Kuo L, Chen J . Lower education level is a major risk factor for peritonitis incidence in chronic peritoneal dialysis patients: a retrospective cohort study with 12-year follow-up. Perit Dial Int. 2013; 33(5):552-8. PMC: 3797674. DOI: 10.3747/pdi.2012.00065. View

20.

von Elm E, Altman D, Egger M, Pocock S, Gotzsche P, Vandenbroucke J . The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008; 61(4):344-9. DOI: 10.1016/j.jclinepi.2007.11.008. View