P178
INTRODUCTION OF TREATMENT DECISION GUIDE AIDS PATIENT CHOICE
Thom, E, Thompson, B, Hanna, L, Brown, J
Renal Patient Education, Nephrology & Transplant Service, Belfast City Hospital, Belfast
Health & Social Care Trust
BACKGROUND: Throughout the UK, the number of Pre-dialysis patients opting for PD as a
treatment option tends to be significantly lower than those choosing HD. In 2011, Belfast Health and
Social Care Trust (BHSCT) had 69 patients commence dialysis. Of this group, 87% commenced
hospital HD, 3% commenced home HD and only 10% commenced PD. Recent research relating to
Patient Education, has shown that patients tend to remember information better when it has been
displayed in a linear format as opposed to sequential (Mooney, et al 2008).Using this knowledge, we
designed and introduced our Patient Treatment Decision Guide last year. It displays information
regarding RRT in a linear format. In conjunction with this, we developed a Decision Review Form.
This allows us to review the patient’s treatment choice with them and see what factors may influence
their decision process. By using our Decision Review Form we were able to audit the Patient
Treatment Decision Guide and found that 64% (14) had indicated that PD would be their preferred
choice. We thought it would be interesting to review this patient group to see where they are at in
their renal journey and if they started on their treatment of choice.
OBJECTIVES: To audit the effectiveness of our Patient Treatment Decision Guide in relation to
empowering patients to make informed decision regarding treatment choice.
METHOD: Patients were given the Patient Treatment Decision Guide at their first education
appointment. At their review appointment, we used the Decision Review Form to clarify their
treatment choice, and to explore factors that may have influenced this decision. By using EMED
(electronic IT system), we followed our patients’ journey to see if treatment choice was achieved.
RESULTS: Of the 22 patients who used the Patient Treatment Decision Guide 64% (14) indicated
that they prefer PD. 5 patients commenced PD. 7 patients continue to be reviewed by PD team. 1
patient was deemed unfit for surgery. 1 patient died. While this is a small sample group, the results
suggest that patients are commencing the treatment of their choice and that more are opting for PD.
CONCLUSION/APPLICATION TO PRACTICE: This small audit has shown that our patients
have started on their preferred treatment choice. We hope that on-going reviews with those remaining
patients will facilitate a planned and timely commencement onto their treatment of choice. The
introduction of the Patient Treatment Decision Guide has been beneficial in presenting information
in a clear and concise format to our patients. By using the Decision Review Form, we have been able
to consider the patients’ decision making process. This allows us to explore the factors which have
influenced their decision, and to gently challenge any misconceptions to ensure a fully informed
decision is reached.