B0789
Title: Graphical and multistate modelling to explore factors influencing home dialysis uptake
Authors: Camille Parsons - Keele University (United Kingdom)
Jessica Potts - Keele University (United Kingdom) [presenting]
Kerry Allen - University of Birmingham (United Kingdom)
Sarah Damery - University of Birmingham (United Kingdom)
Lisa Dikomitis - Keele University (United Kingdom)
James Fotheringham - University of Sheffield (United Kingdom)
Harry Hill - University of Sheffield (United Kingdom)
Mark Lambie - Keele University (United Kingdom)
Louise Phillips-Darby - Keele University (United Kingdom)
Iestyn Williams - University of Birmingham (United Kingdom)
Simon Davies - Keele University (United Kingdom)
Ivonne Solis-Trapala - Keele University (United Kingdom)
Abstract: Renal replacement therapy (RRT) takes the form of home or in-centre dialysis or kidney transplantation. Home dialysis provides increased control and freedom for patients, especially in those in employment or wishing to travel. However, the use of home dialysis varies considerably across the UK and is decreasing despite attempts to encourage greater use. The Intervening to eliminate the centre-effect variation in home dialysis use (Inter-CEPt) study uses a mixed-methods approach to explore the factors driving access to home therapies to develop a cost-effective intervention. A qualitative analysis informed the design of a national survey of renal centres and the development of a chain graph model to describe the complex interrelations among patient- and centre-level factors leading to the uptake of home dialysis, based on the survey data linked to the UK Renal Registry (UKRR) which collates patient-level data from renal centres across the UK. Multistate models were developed to estimate the rates of transition from and to home, in-centre dialysis, and transplantation, and to death informed by the graphical model, for health economics analysis. We will discuss initial statistical analysis results highlighting the challenges of working with real-world data.
