SP831
ROUTINE USE OF DECISION MAKING TOOLS INCREASES PERITONEAL DIALYSIS CHOICE AND TAKE ON IN AN INTERNATIONAL SETTING

INTRODUCTION AND AIMS: Lack of patient choice or inability to offer high quality modality information programs remain as causes for low PD use. Objectives: To analyze the impact of a structured modality information program with the use of decision making tools (DMTs) on type of modality choice and start.

METHODS: Observational, prospective and international registry. All patients under ESRD 4-5 and/or after an unplanned dialysis start (if non-informed before) were recruited to undergo a DMTs process for RRT choice. Process included: personal values evaluation, RRT information with different tools, deliberation support and patient´s modality election.

RESULTS: 1141 patient-aimed modality information between Aug. 2014-Dec. 2015 in 45 clinics (Poland, Romania, Hungary, Germany and Argentina). Staff considered PD as contraindicated in 32%. 800 patients (mean 59,5 y.) were considered optimal for HD/PD (48% were prone for a home therapy). Written information was largely used for 69-95% of patients; DVD in 14-30% and in centre HD/PD touring visits in 10-76%. Relatives’ participation in the process was 82%. PD choice (39%) varied among countries: 16% (RO, 12 clinics), 38% (PL, 19 cl.) 41% (HU, 10 cl.), 84% (GE, 3 cl.) and 93% (AR,1 cl.). For patients who started dialysis (n= 612), PD as chronic RRT reached 31% (10% with an unplanned HD start); 13% (RO), 30% (PL), 36% (HU), 75% (GE), 93% (AR).

CONCLUSIONS: Use of DMTs at the time of RRT modality choice complies with patient empowerment. A remarkable increase in PD take-on occurred in our clinic network after DMTs process introduction. Therefore, modality information should always be delivered through a structured information process based on decision sharing.