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Clinicians' and researchers' perspectives on establishing and implementing core outcomes in haemodialysis: semistructured interview study

Tong, A; Crowe, S; Gill, JS; Harris, T; Hemmelgarn, B; Manns, B; Tugwell, P; ... Craig, J; + view all (2018) Clinicians' and researchers' perspectives on establishing and implementing core outcomes in haemodialysis: semistructured interview study. BMJ Open , 8 (4) , Article e021198. 10.1136/bmjopen-2017-021198. Green open access

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Abstract

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.

Type: Article
Title: Clinicians' and researchers' perspectives on establishing and implementing core outcomes in haemodialysis: semistructured interview study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjopen-2017-021198
Publisher version: https://doi.org/10.1136/bmjopen-2017-021198
Language: English
Additional information: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Renal Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10046173
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