Gilbert L Queeley1, Ellen S Campbell2, Askal A Ali3. 1. Research Associate, Division of Economic, Social, and Administrative Pharmacy, College of Pharmacy and Pharmaceutical Sciences, Florida A&M University Tallahassee. 2. Associate Professor, Division of Economic, Social, and Administrative Pharmacy, College of Pharmacy and Pharmaceutical Sciences, Florida A&M University Tallahassee. 3. Assistant Professor, Division of Economic, Social, and Administrative Pharmacy, College of Pharmacy and Pharmaceutical Sciences, Florida A&M University Tallahassee.
Abstract
BACKGROUND: Hemodialysis is a procedure that requires efficient removal and return of blood to a patient's body. Despite being a life-sustaining process, hemodialysis is associated with morbidity, mortality, and high societal costs. A significant part of the financial costs to patients and society at large can be attributed to vascular access dysfunction. The cornerstone to efficient hemodialysis is a well-functioning vascular access that simultaneously allows efficient blood flow for dialysis and easy cannulation. It is hypothesized that the poor health outcomes associated with vascular access dysfunction can be improved by paying closer attention to patient-specific factors in clinical guidelines for hemodialysis vascular access. This may require a shift to a more patient-centered approach to vascular access management. OBJECTIVE: To assess the presence of patient-specific treatment recommendations in the current clinical practice guidelines for hemodialysis vascular access. METHODS: We conducted a systematic search of PubMed and professional nephrology organization websites for full-text clinical practice guidelines with treatment recommendations regarding hemodialysis vascular access. We developed a coding sheet to document the number of patient-specific treatment recommendations and other quality attributes found in the extracted clinical practice guidelines. RESULTS: Our search resulted in the extraction of 5 clinical practice guidelines for final review. Only 1 of the 5 extracted guidelines was found to contain patient-specific treatment recommendations, but the treatment recommendations were limited to juvenile patients. Of the 5 clinical practice guidelines, 4 were published within the past decade (ie, after 2006). CONCLUSION: Our findings show that current clinical practice guidelines for hemodialysis vascular access lack patient-specific recommendations. Future clinical guidelines must consider patient-specific treatment recommendations with the goal of improving hemodialysis vascular access outcomes for patients, a goal that is supported in the recommendations of the National Kidney Foundation.
BACKGROUND: Hemodialysis is a procedure that requires efficient removal and return of blood to a patient's body. Despite being a life-sustaining process, hemodialysis is associated with morbidity, mortality, and high societal costs. A significant part of the financial costs to patients and society at large can be attributed to vascular access dysfunction. The cornerstone to efficient hemodialysis is a well-functioning vascular access that simultaneously allows efficient blood flow for dialysis and easy cannulation. It is hypothesized that the poor health outcomes associated with vascular access dysfunction can be improved by paying closer attention to patient-specific factors in clinical guidelines for hemodialysis vascular access. This may require a shift to a more patient-centered approach to vascular access management. OBJECTIVE: To assess the presence of patient-specific treatment recommendations in the current clinical practice guidelines for hemodialysis vascular access. METHODS: We conducted a systematic search of PubMed and professional nephrology organization websites for full-text clinical practice guidelines with treatment recommendations regarding hemodialysis vascular access. We developed a coding sheet to document the number of patient-specific treatment recommendations and other quality attributes found in the extracted clinical practice guidelines. RESULTS: Our search resulted in the extraction of 5 clinical practice guidelines for final review. Only 1 of the 5 extracted guidelines was found to contain patient-specific treatment recommendations, but the treatment recommendations were limited to juvenile patients. Of the 5 clinical practice guidelines, 4 were published within the past decade (ie, after 2006). CONCLUSION: Our findings show that current clinical practice guidelines for hemodialysis vascular access lack patient-specific recommendations. Future clinical guidelines must consider patient-specific treatment recommendations with the goal of improving hemodialysis vascular access outcomes for patients, a goal that is supported in the recommendations of the National Kidney Foundation.
Authors: Stephen M Rupp; Jeffrey L Apfelbaum; Casey Blitt; Robert A Caplan; Richard T Connis; Karen B Domino; Lee A Fleisher; Stuart Grant; Jonathan B Mark; Jeffrey P Morray; David G Nickinovich; Avery Tung Journal: Anesthesiology Date: 2012-03 Impact factor: 7.892
Authors: Melissa C Brouwers; Michelle E Kho; George P Browman; Jako S Burgers; Francoise Cluzeau; Gene Feder; Béatrice Fervers; Ian D Graham; Jeremy Grimshaw; Steven E Hanna; Peter Littlejohns; Julie Makarski; Louise Zitzelsberger Journal: CMAJ Date: 2010-07-05 Impact factor: 8.262
Authors: Leonard A Mermel; Michael Allon; Emilio Bouza; Donald E Craven; Patricia Flynn; Naomi P O'Grady; Issam I Raad; Bart J A Rijnders; Robert J Sherertz; David K Warren Journal: Clin Infect Dis Date: 2009-07-01 Impact factor: 9.079
Authors: Tushar J Vachharajani; Shahriar Moossavi; Jean R Jordan; Vidula Vachharajani; Barry I Freedman; John M Burkart Journal: Clin J Am Soc Nephrol Date: 2011-06-16 Impact factor: 8.237
Authors: Karen Woo; Jesus Ulloa; Michael Allon; Christopher G Carsten; Eric S Chemla; Mitchell L Henry; Thomas S Huber; Jeffrey H Lawson; Charmaine E Lok; Eric K Peden; Larry Scher; Anton Sidawy; Melinda Maggard-Gibbons; David Cull Journal: J Vasc Surg Date: 2017-02-17 Impact factor: 4.268
Authors: Anton N Sidawy; Lawrence M Spergel; Anatole Besarab; Michael Allon; William C Jennings; Frank T Padberg; M Hassan Murad; Victor M Montori; Ann M O'Hare; Keith D Calligaro; Robyn A Macsata; Alan B Lumsden; Enrico Ascher Journal: J Vasc Surg Date: 2008-11 Impact factor: 4.268
Authors: Sabine N van der Veer; Maria C Haller; Carina A C M Pittens; Jacqueline Broerse; Clare Castledine; Maurizio Gallieni; Nicholas Inston; Anna Marti Monros; Niels Peek; Wim van Biesen Journal: PLoS One Date: 2015-07-07 Impact factor: 3.240