Barriers and facilitators for the adoption of peritoneal dialysis: protocol for a systematic review of qualitative studies

Abstract

Introduction Peritoneal dialysis (PD) is an effective home-based treatment for end-stage kidney disease (ESKD) that offers several advantages over in-centre haemodialysis, including better quality of life, increased autonomy and lower costs. Despite these benefits, PD remains underused globally, with wide variations in adoption rates across countries. Qualitative studies have explored the experiences, perceptions and decision-making processes of patients, caregivers and healthcare providers regarding PD, but their findings have not been systematically synthesised. This protocol outlines a systematic review of qualitative studies to identify and synthesise the multilevel factors that influence PD adoption.Methods and analysis We will conduct a comprehensive search of electronic databases (PubMed, Web of Science, Embase, CINAHL, MEDLINE, The Cochrane Library, PsycINFO, Scopus) and grey literature sources for qualitative studies published in English from each database inception to June 2024 that explore barriers and facilitators to PD adoption. Two reviewers will independently screen titles, abstracts and full texts for eligibility based on predefined criteria. Eligible studies will include those that use qualitative methods (eg, interviews, focus groups, observations) to explore the perspectives of adult ESKD patients, their caregivers and/or healthcare providers on factors influencing PD adoption, initiation or maintenance. Data will be extracted using a standardised form and synthesised using thematic analysis. The methodological quality of included studies will be appraised using the Critical Appraisal Skills Programme Qualitative Checklist. Confidence in the review findings will be assessed using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research approach.Ethics and dissemination Ethics approval is not required as this study will merely synthesise data from published studies. The results will be disseminated through peer-reviewed publications as well as conference presentations.Study registration PROSPERO, CRD42024570521.