Shared care: a pathway for the rejuvenation of home haemodialysis?

There much evidence for the benefits to patients of being able to manage their own haemodialysis rather following the thrice weekly model of most in-centre dialysis programmes. Numbers of patients dialysing at home remains disappointingly small and there are considerable variations between renal centres. Shared care models have been promoted as a route of encouraging greater take-up of home haemodialysis (HHD). There is currently little available evidence to support this assertion. Barriers have been identified to increasing self-management by haemodialysis patients, many of which apply to both shared care and HHD programmes. Overcoming the barriers, many of which are institutional is key to increasing numbers of patients dialysing at home. The development of shared care initiatives alone will not foster greater HHD engagement rather the cultural and other barriers to both must be overcome if such growth is to be seen

Home dialysis : overcoming barriers and encouraging independence

Home haemodialysis has been recognised by policy makers as a modality which has the potential to empower patients with kidney disease. However, despite the benefits of having dialysis at home, several barriers exist to its widespread use. Susan Eldose and Dilla Davis explore measures which could be adopted in clinical practice to help clinicians and patients overcome challenges in this therapy area