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.
ContributorsTong, A. Crowe, S. Gill, J. S. Harris, T. Hemmelgarn, B. R. Manns, B. Pecoits-Filho, R. Tugwell, P. van Biesen, W. Wang, A. Y. M. Wheeler, D. C. Winkelmayer, W. C. Gutman, T. Ju, A. O'Lone, E. Sautenet, B. Viecelli, A. Craig, J. C.
Disease Category: Kidney disease
Disease Name: Chronic kidney disease
Age Range: Unknown
Sex: Either
Nature of Intervention: Procedure
- Clinical experts
- Researchers
- COS for clinical trials or clinical research
- COS for practice
- Interview