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At the 2010 congress of the ASN, DOPPS launched an exciting new initiative known as
the DOPPS Practice Monitor, or DPM. The DPM aims to analyze and report temporal changes in U.S.
clinical practices, facility services offered, and performance measure achievement. The advancement
of the DPM initiative is especially timely now that CMS has implemented its fully bundled end-stage
renal disease (ESRD) prospective payment system (PPS). Pressures exerted by payment changes, and their
effects on clinical practice, are likely to vary among dialysis facilities, with some facilities affected
more than others. The ability to monitor trends in dialysis care as the fully bundled PPS is implemented will
be of pivotal importance to patients, providers, and the dialysis community. Based on an enhanced DOPPS study design,
the DPM is poised to be a vital independent data source to report changes in dialysis practice and the impact on
clinical care for ESRD patients in the U.S.
For the most recent findings from 2010 to 2011 in mineral bone disorder and anemia, please click here. For more information and to see the most recent results from the latest update in January 2012 – please click the link to the right.
We are pleased to announce the commencement of the DOPPS Saudi Arabia Pilot study. The primary aim of the pilot study is to demonstrate the feasibility of applying the DOPPS protocol to another culture, which we most recently completed with great success in China. Pilot study data collection is currently underway in 20 dialysis units. The DOPPS is working closely with key nephrology opinion leaders in Saudi Arabia. To more fully understand factors that influence practice patterns in dialysis care, it is vital to expand the study to include countries with greater variation in practice patterns. We look forward to the first preliminary analyses of these data.
Ron Pisoni, PhD, MS, Senior Research Scientist, will be presenting on the DOPPS Practice Monitor providing the latest results and trends in US HD practice. Additionally, where possible, the presentation will focus on describing relationships observed thus far regarding particular patient laboratory measures as it relates to changes in facility practice. The presentation will be during the talk entitled, “Dialysis administrative Issues: Bundling One Year Later.” Mark Neumann, BS and Sally Burrows-Hudson, MSN, RN are presiding.
The presentation is entitled "The Dialysis Outcomes and Practice Patterns Study (DOPPS) Practice Monitor: Following Trends in Bundled Payment in the US” and will be given by Donna Mapes, DNSc, MS, RN. The session aims to give the audience a greater understanding of the bundled end-stage renal disease Prospective Payment System (PPS) and explain the goals, reporting system, accessibility and value to providers of the DPM initiative released in late 2010.
The DOPPS will also have a booth – number 118 – where meeting attendees can receive more information, giveaways, publications and much more!
Bruce Robinson, MD, MS, FACP has been invited by NKF to give the following lecture: “Changes in Practice Patterns and Laboratory Values” to take place on May, 12th 3:30-5:00pm during the session: “The Impact of Bundling on Clinical Practice.” Check back later in the year for more details regarding this lecture and additional updates.
Visit our booth at the conference – number TBA – where conference attendees will be able to view the DOPPS Practice Monitor website and explore the newest trends in US HD practice!
We are pleased to announce that the DOPPS session titled, “Correlating International Hemodialysis Practice Differences with Outcomes: The Dialysis Outcomes and Practice Patterns Study (DOPPS)” was accepted onto the scientific program during the congress. The session, featuring an international panel of speakers, will include information on the practice before and after policy change, transitions from CKD to dialysis, indicators related to Mineral Bone Disorder and vascular access. Check back later for more information regarding additional DOPPS presentations.
Stop by booth number 1.G7 to speak with a DOPPS representative, receive publications and giveaways!
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 The DOPPS has published more than 100 papers in peer-reviewed medical journals,
as well as numerous articles in textbooks and other forums.
See our Publications section for detail on the full range of DOPPS publications.
Changes in anemia management and hemoglobin levels in Japan following implementation of a bundling policy to incorporate erythropoietin
In 2006, Japan’s health insurance system instituted a bundling policy that included recombinant human erythropoietin (rHuEPO) in outpatient hemodialysis therapy. Analysis of data from the Japan DOPPS found the bundling policy was associated with reduced rHuEPO doses, increased intravenous iron use, and stable hemoglobin levels in Japanese patients receiving hemodialysis. (Kidney Int print publication, February 2011)
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Naturally occurring higher hemoglobin concentrations are not associated with increased mortality among hemodialysis patients
This report examines the prevalence of endogenous erythropoietin (EPO) status and provides perspective to the consideration of hemoglobin concentration and clinical outcomes in hemodialysis. The findings from this study show no evidence of increased mortality risk associated with higher hemoglobin in patients with higher endogenous EPO. (J Am Soc Nephrol e-publication, December 2010)
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Hemodialysis vascular access training and practices are key to improved access outcomes
This article provides a detailed review of major findings regarding worldwide use of the arteriovenous fistula as a vascular access. It features often overlooked, yet important issues such as dialysis staff preferences for access type, emphasis on fistula placement, and adequate surgical training to create fistulae. (Am J Kidney Disease print publication, December 2010)
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Associations of social support and other psychosocial factors with mortality and quality of life in the DOPPS
Dialysis patients often feel stressed about time they spend away from family and friends to receive treatments. They may even feel guilty for being ill and hesitant to ask for support. Psychosocial factors have been associated with a patient’s adjustment to dialysis, and social support has been linked to improved health outcomes in community and clinical samples. (Clin J Am Soc Nephrol print publication, January 2011)
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Regular exercise is associated with better outcomes among hemodialysis patients
Physical exercise levels are often very low among hemodialysis patients. Increased physical activity has been associated with improved health-related quality of life (HRQoL) and survival for these patients. Analyses sought to determine patterns of exercise and associated outcomes among hemodialysis patients internationally. The DOPPS results support a strong association of regular exercise with higher HRQoL and longer survival. (Nephrol Dial Transplant print publication, September 2010)
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Routine measurement of C-reactive protein (CRP) levels may lead to improved care of hemodialysis patients
High levels of the inflammatory marker CRP have been associated with cardiovascular and all-cause mortality in patients with chronic kidney disease. Analyses were conducted to assess the influence of CRP on mortality and outcomes (all-cause and cardiovascular mortality). Cardiovascular and all-cause mortality were significantly associated with high CRP levels. (Nephron Clin Pract print publication, August 2010)
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Multiple measures are needed to assess the joint effects of nutritional indicators on mortality
Because not one of the nutritional indicators (such as serum albumin, serum creatinine, body mass index, and normalized protein catabolic rate) commonly used for measuring the nutritional status of a dialysis patient can provide a comprehensive description of nutritional status, the KDOQI recommends multiple measurements. This study considered the effects of both independent and joint associations of nutritional indicators on the risk of death and how these indicators differed among patient characteristics and country. (J Renal Nutr print publication, July 2010)
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