{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:08:25Z","timestamp":1762866505285,"version":"3.33.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2014,1,10]],"date-time":"2014-01-10T00:00:00Z","timestamp":1389312000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> The purpose of this study is to explore how vascular access care was reimbursed, promoted, and organised at the national level in European and neighbouring countries. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> An electronic survey among national experts to collect country-level data. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Forty-seven experts (response rate, 76%) from 37 countries participated. Experts from 23 countries reported that 50% or less of patients received routine pre-operative imaging of vessels. Nephrologists placed catheters and created fistulas in 26 and 8 countries, respectively. Twenty-one countries had a fee per created access; the reported fee for catheter placement was never higher than for fistula creation. As the number of haemodialysis patients in a centre increased, more countries had a dedicated coordinator or multidisciplinary team responsible for vascular access maintenance at the centre-level; in 11 countries, responsibility was always with individual nephrologists, independent of a centre's size. In 23 countries, dialysis centres shared vascular access care resources, with facilitation from a service provider in 4. In most countries, national campaigns (n = 35) or educational programmes (n = 29) had addressed vascular access-related topics; 19 countries had some form of training for creating fistulas. Forty experts considered the current evidence base robust enough to justify a fistula-first policy, but only 13 believed that more than 80% of nephrologists in their country would attempt a fistula in a 75-year-old woman with comorbidities. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Suboptimal access to surgical resources, lack of dedicated training of clinicians, limited routine use of pre-operative diagnostic imaging and patient characteristics primarily emerged as potential barriers to adopting a fistula-first policy in Europe. <\/jats:p><\/jats:sec>","DOI":"10.5301\/jva.5000313","type":"journal-article","created":{"date-parts":[[2014,11,3]],"date-time":"2014-11-03T09:24:51Z","timestamp":1415006691000},"page":"113-119","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":23,"title":["Barriers to Adopting a Fistula-First Policy in Europe: An International Survey among National Experts"],"prefix":"10.1177","volume":"16","author":[{"given":"Sabine N.","family":"van der Veer","sequence":"first","affiliation":[{"name":"European Renal Best Practice (ERBP) Methods Support Team, University Hospital Ghent, Ghent - Belgium"},{"name":"Department of Medical Informatics, Academic Medical Center, Amsterdam -The Netherlands"}]},{"given":"Pietro","family":"Ravani","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, Department of Medicine, University of Calgary, Calgary, Alberta - Canada"}]},{"given":"Luis","family":"Coentr\u00e3o","sequence":"additional","affiliation":[{"name":"Nephrology and Infectious Diseases Research and Development Group, INEB-(I3S), University of Porto, Porto - Portugal"}]},{"given":"Richard","family":"Fluck","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine, Royal Derby hospital, Derby - UK"}]},{"given":"Werner","family":"Kleophas","sequence":"additional","affiliation":[{"name":"MVZ DaVita (Karlstrasse), D\u00fcsseldorf - Germany"},{"name":"Department of Nephrology, Heinrich-Heine University, D\u00fcsseldorf - Germany"}]},{"given":"Laura","family":"Labriola","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Cliniques Universitaires Saint-Luc, Universit\u00e9 Catholique de Louvain, Brussels - Belgium"}]},{"given":"Susanne H.","family":"Hoischen","sequence":"additional","affiliation":[{"name":"Diaverum Deutschland, M\u00fcnchen - Germany"}]},{"given":"Marlies","family":"Noordzij","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, Academic Medical Center, Amsterdam -The Netherlands"},{"name":"ERA-EDTA Registry, Academic Medical Center, Amsterdam -The Netherlands"}]},{"given":"Kitty J.","family":"Jager","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, Academic Medical Center, Amsterdam -The Netherlands"},{"name":"ERA-EDTA Registry, Academic Medical Center, Amsterdam -The Netherlands"}]},{"given":"Wim","family":"van Biesen","sequence":"additional","affiliation":[{"name":"European Renal Best Practice (ERBP) Methods Support Team, University Hospital Ghent, Ghent - Belgium"},{"name":"Renal Division, University Hospital Ghent, Ghent - Belgium"}]}],"member":"179","published-online":{"date-parts":[[2014,1,10]]},"reference":[{"doi-asserted-by":"publisher","key":"bibr1-jva.5000313","DOI":"10.1111\/nep.12132"},{"author":"Fluck R.","journal-title":"Clinical practice guidelines vascular access for haemodialysis.","key":"bibr2-jva.5000313"},{"issue":"2","key":"bibr3-jva.5000313","first-page":"ii88","volume":"22","author":"Tordoir J.","year":"2007","journal-title":"Nephrol Dial Transplant."},{"issue":"1","key":"bibr4-jva.5000313","first-page":"S176","volume":"48","author":"National Kidney Foundation Vascular Access Work Group.","year":"2006","journal-title":"Am J Kidney Dis."},{"doi-asserted-by":"publisher","key":"bibr5-jva.5000313","DOI":"10.1111\/j.1525-139X.2009.00675.x"},{"doi-asserted-by":"publisher","key":"bibr6-jva.5000313","DOI":"10.1093\/ndt\/gfu253"},{"doi-asserted-by":"publisher","key":"bibr7-jva.5000313","DOI":"10.1093\/ndt\/gft496"},{"volume-title":"Clinical practice guidelines we can trust.","year":"2011","author":"Institute of Medicine.","key":"bibr8-jva.5000313"},{"doi-asserted-by":"publisher","key":"bibr9-jva.5000313","DOI":"10.1001\/jama.282.15.1458"},{"doi-asserted-by":"publisher","key":"bibr10-jva.5000313","DOI":"10.1093\/ckj\/sft020"},{"doi-asserted-by":"publisher","key":"bibr11-jva.5000313","DOI":"10.1053\/j.ajkd.2010.12.020"},{"doi-asserted-by":"publisher","key":"bibr12-jva.5000313","DOI":"10.1093\/ndt\/gfq064"},{"doi-asserted-by":"publisher","key":"bibr13-jva.5000313","DOI":"10.1111\/sdi.12046"},{"doi-asserted-by":"publisher","key":"bibr14-jva.5000313","DOI":"10.1097\/SLA.0b013e31816c4044"},{"doi-asserted-by":"publisher","key":"bibr15-jva.5000313","DOI":"10.1038\/ki.2011.222"},{"doi-asserted-by":"publisher","key":"bibr16-jva.5000313","DOI":"10.1681\/ASN.2012070643"},{"doi-asserted-by":"publisher","key":"bibr17-jva.5000313","DOI":"10.1093\/ndt\/gfn261"},{"doi-asserted-by":"publisher","key":"bibr18-jva.5000313","DOI":"10.1016\/j.jvs.2012.11.094"},{"unstructured":"RussellC., PolkinghorneK. KHA-CARI guideline: pre-operative examination of the vessels: diagnostic evaluation prior to permanent access selection; Published by Kidney Health Australia - Caring for Australasians with Renal Impairment (KHA-CARI), Jan 2012. Available at http:\/\/www.cari.org.au\/Dialysis\/dialysis_guidelines.html. 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