The Pre-Dialysis Care Trajectory of Chronic Kidney Disease Patients and the Start of Dialysis in Emergency: A Mixed Method Study Protocol

Maxime Raffray, Sahar Bayat, Arnaud Campéon, Laëtitia Laude and Cécile Vigneau
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Maxime Raffray: Univ Rennes, French School of Public Health (EHESP), Pharmaco-epidemiology and health Services Research, (REPERES)-EA 7449, 35043 Rennes, France
Sahar Bayat: Univ Rennes, French School of Public Health (EHESP), Pharmaco-epidemiology and health Services Research, (REPERES)-EA 7449, 35043 Rennes, France
Arnaud Campéon: EHESP, Arènes, CNRS, UMR 6051, 35043 Rennes, France
Laëtitia Laude: EHESP, Health Organizations Management (MOS)-EA 7348, 35043 Rennes, France
Cécile Vigneau: Department of Nephrology, Centre Hospitalier Universitaire, 35000 Rennes, France

IJERPH, 2019, vol. 16, issue 24, 1-11

Abstract: Chronic Kidney Disease (CKD) is an important public health issue that requires early and close medical monitoring to start Renal Replacement Therapy (RRT) in the best conditions. However, in France, about 1/3 of patients start dialysis in emergency, despite the existence of CKD management guidelines. Using both quantitative and qualitative methods, we wanted to analyze the pre-dialysis care trajectory of patients with CKD and document the causes of Emergency dialysis Start (ES). To this aim, we designed a convergent mixed-method study. The quantitative component will analyze individual healthcare consumption and clinical data to identify the risk factors of ES by comparing the trajectories of patients who started dialysis in emergency in 2015 in France with those of patients who started in a planned manner and with the national recommendations. The qualitative component will explore the patients’ trajectories and identify barriers to a planned start using semi-structured interviews with patients who started dialysis in emergency and with their general practitioners and nephrologists. Using the strengths of a mixed methodology, this study will bring robust and valuable findings to improve the care of CKD patients.

Keywords: chronic kidney disease; care trajectory; mixed methods; emergency start dialysis; big data (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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