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

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: (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); (realistic and possible to intervene on, differentiating between treatments); (clarity and consistency in definition, easily measurable, requiring minimal resources, creating a cultural shift, aversion to intensifying bureaucracy, allowing justifiable exceptions); (endorsement for legitimacy, necessity of buy-in from dialysis providers, incentivising uptake); (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.