Study of Patient Preferences in Dialysis Treatment Choice: a Discrete Choice Experiment

NCT07535320 | Recruiting

• 1 other identifier: 24-0172
• Study Type: observational
• Target: 500
• Locations: 1 country
• Sites: 2

Brief Summary

Background Compared to in-center dialysis, home dialysis is associated with better quality of life and lower healthcare system costs. However, barriers remain to its wider adoption. Chronic disease, particularly at an advanced stage, is a major driver of socioeconomic vulnerability. Among dialysis patients, the proportion of individuals covered by France's Universal Health Protection scheme (PUMA) is higher than in the general population. Similarly, those from the most disadvantaged social classes are overrepresented among dialysis patients compared to the overall French population. Dialysis can also lead to job loss. Financial compensation schemes may influence the choice of home dialysis. In France, patients who perform dialysis at home-either independently or with help from a trained family caregiver-are eligible for a "third-person compensatory allowance" (DTP). For some socioeconomically vulnerable patients, eligibility for DTP may influence their decision to opt for home treatment. The DTP is specific to the French healthcare system but could be considered in other countries, particularly within the European Union. Indeed, in most countries with income levels comparable to France, the additional cost of home dialysis is borne by the patient. This study aims to determine whether receiving financial compensation plays a role in choosing a dialysis modality (home-based versus in-center or assisted home dialysis). Objectives To investigate factors associated with patient preferences regarding renal replacement therapy. Methods A discrete choice experiment (DCE) was conducted comparing two options: home dialysis (PD and HHD, with DTP) versus in-center hemodialysis (no DTP). Perspectives If financial compensation influences patients' choices toward home dialysis, the DTP model could be used to address barriers to home-based treatment.

Conditions

End Stage Chronic Renal Failure

Keywords

Nephrology; Home Dialysis; Chronic Kidney Disease; Discrete Choice Experiment

Outcome Measures

Primary Outcomes (1)

• Preference coefficients for renal replacement therapy attributes, including monthly financial allowance, estimated using a discrete choice experiment

  Participants will complete 13 discrete choice tasks, each requiring selection of one preferred scenario among three renal replacement therapy options. Scenarios are defined by combinations of five attributes: schedule flexibility, nurse availability, dialysis frequency, timing of sessions, and monthly financial allowance. Preferences will be analyzed within a random utility framework using a mixed logit model. The primary outcome is the estimation of marginal utilities (preference coefficients) associated with each attribute level. Particular focus will be placed on the coefficient associated with the monthly financial allowance attribute, to assess its influence on the probability of choosing a home-based treatment modality. This approach allows indirect elicitation of patient preferences without explicit ranking, consistent with economic theory of revealed preferences.

  Baseline (during the single discrete choice experiment assessment at study enrollment)

Study Arms (1)

Choice of dialysis

Patients with an end-stage renal disease who need to make a choice concerning their prefered dialysis' modality

Other: Questionnaire

Interventions

Questionnaire OTHER

Patients are given a questionnaire. The first part concerns sociodemographic characteristics. The second part concerns the choice of replacement therapy itself. Patients must choose between three possible treatments: "If you had to choose a treatment based on the options provided, which one would you choose? Patients make this choice 13 times (the options change).

Choice of dialysis

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients with chronic kidney disease in the advanced stage

You may qualify if:

• Adult patient
• Patient with advanced chronic kidney disease receiving pre-surgery information (presentation of methods)
• Patient enrolled in a social security program
• Patient able to read and understand French
• Patient able to complete the questionnaire (cognitive and sensory)

You may not qualify if:

• Minor patients
• Patients transitioning from one method of extrarenal purification to another
• Patients requiring urgent dialysis
• Patients who cannot read or understand French
• Patients under legal protection (guardianship, curatorship, judicial protection)

Sponsors & Collaborators

• University Hospital, Caen: lead

Study Sites (2)

CHU de Caen

Caen, 14000, France

RECRUITING

CHU

Caen, 14000, France

RECRUITING

MeSH Terms

Conditions

Renal Insufficiency, Chronic

Interventions

Surveys and Questionnaires

Condition Hierarchy (Ancestors)

Renal Insufficiency; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Data Collection; Epidemiologic Methods; Investigative Techniques; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Public Health; Environment and Public Health

Central Study Contacts

Clémence Tomadesso, Mrs

CONTACT

+33231063106; tomadesso-c@chu-caen.fr

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: OTHER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 25, 2025
• First Posted: April 17, 2026
• Study Start: December 16, 2025
• Primary Completion (Estimated): December 31, 2027
• Study Completion (Estimated): December 31, 2027
• Last Updated: April 17, 2026

Record last verified: 2025-12

Locations

FR (2)