Decision-making process in the selection of home hemodialysis treatment by adult patients with end-stage renal disease in the United Kingdom: A systematic literature review

Introduction: In the UK, the number of people diagnosed with renal disease is on the increase. As a result, there will be more people in need of renal replacement therapy (RRT). Despite the mounting evidence showing that home hemodialysis (HHD) treatment is clinical and cost-effective as well as amendable to suit patients' lifestyle, the number of patients choosing this dialysis modality is low. The aim of this study is to explore factors influencing decision-making process in the selection of HHD treatment for adult patients with end-stage renal disease in the UK. Methods: A systematic literature review methodology was utilized to review, critique, and synthesize the literature on the low uptake of HHD among adult patients. Systematic searches involving the databases Google Scholar, EMBASE, MEDLINE, PsycINFO, and CINAHL were carried out for articles published from 2008 to 2021. A search was conducted from June 1 through December 23, 2020. Eight articles met the study inclusion criteria. We followed preferred Reporting Items for Systematic Reviews and Meta-analyses in designing the research and reporting. Results: This systematic review revealed that patient information needs, dialysis education, training and support, and patient decision-making preference were the major factors influencing decision-making of adult patients. Conclusion: Deciding over which dialysis modality to choose can be challenging for many adult patients. Dialysis education, training, and support should not stop at the predialysis stage but should continue during treatment.