Targeted Education ApproaCH to Improve Peritoneal Dialysis Outcomes Cluster Randomised Controlled Trial (TEACH-PD)
Overview
TEACH‑PD is a large, registry-based clinical trial testing whether a standardised peritoneal dialysis (PD) training program can reduce infections and improve patient outcomes. The trial is a collaboration between the Australasian Kidney Trials Network (AKTN), ANZDATA, and kidney clinicians and nurses across Australia and New Zealand.
Infections related to PD, such as peritonitis and exit site infections, are a leading cause of treatment failure. The rates of these infections vary widely between centres, largely due to differences in training practices rather than patient factors. Some of the centre-specific disparity in outcomes, including peritonitis rates, has been attributed to variable attention paid by centres to potentially modifiable peritonitis risk factors, including training practices. TEACH‑PD will evaluate whether using a standardised, evidence-based training curriculum for PD trainers and patients reduces the rate of PD-related infections and improves technique survival, resulting in better outcomes for patients receiving PD and significant cost-savings to the community.
The TEACH‑PD modules were developed by the HOME Network, AKTN, eLearning experts, education specialists, and consumer representatives, based on ISPD guidelines and adult learning principles. The trial is funded by the BEAT‑CKD Program, ISPD, Baxter, Queensland Health, Metro South Health, and the MRFF Rare Diseases and Unmet Need Initiative.
| Principal Investigators: | Prof Josephine Chow, Prof Neil Boudville |
| Clinical Project Manager | Pushparaj Velayudham |
| Clinical Research Associate: | Misa Matsuyama |
| Trial Number: | AKTN 17.03 |
| Trial Registration Number: | NCT03816111 |
| Population: | Patients commencing Peritoneal Dialysis for the first time who require training |
| Intervention: | PD training using TEACH-PD training modules |
| Follow-up: | 2 years |
| Primary outcome: | Time to the first occurrence of any PD-related infection (exit site infection, tunnel infection or peritonitis) |
| Status: | Recruitment completed |
| Target Recruitment: | 1500 participants across 44 centres in Australia and New Zealand |
| Latest Output: | Multi-center, pragmatic, cluster-randomized, controlled trial of standardized peritoneal dialysis (PD) training versus usual care on PD-related infections (the TEACH-PD trial): trial protocol |
Research Team
Prof Neil Boudville
University of Western Australia & Sir Charles Gairdner Hospital
Prof Josephine S Chow
South Western Sydney Local Health District
Background
Peritoneal dialysis (PD)–related infections, such as peritonitis, exit site infections, and tunnel infections, are a major threat to the long-term success of PD and a top priority concern for patients, caregivers, and clinicians. Although nurse-led training is critical to helping patients manage their own care, PD training programs have traditionally varied between centres, often lacking a strong evidentiary base or standardisation.
To address this, a group of renal nurses from the HOME Network, in collaboration with nephrologists, education experts, and consumer representatives, developed the TEACH‑PD training modules. The curriculum was designed in line with International Society for Peritoneal Dialysis (ISPD) guidelines, using modern adult learning principles proven to enhance teaching effectiveness.
In 2018, a feasibility study tested the acceptability and usability of the TEACH‑PD modules in real-world clinical settings. The results informed further refinement of both the content and delivery of the training program. Building on this groundwork, TEACH‑PD is now being tested in a large, registry-based, cluster-randomised controlled trial across Australia and New Zealand. The trial will assess whether standardising PD training for both PD trainers and patients can reduce infection rates and improve patient outcomes compared to usual care.
Study Aims
TEACH‑PD is a registry-based, pragmatic, cluster-randomised controlled trial designed to provide high-certainty evidence on whether implementing a standardised peritoneal dialysis training curriculum, informed by International Society for Peritoneal Dialysis (ISPD) guidelines, for both PD trainers and adult patients reduces the risk of PD-related infections.
The trial specifically aims to determine whether this training approach extends the time to first occurrence of a composite endpoint of exit site infection, tunnel infection, or peritonitis in people commencing PD, compared with existing local training practices.
Study Design and Population
| Design: | Registry-based, pragmatic, open-label, multi-centre, binational, cluster randomised controlled trial |
| Setting: | 44 peritoneal dialysis units in Australia and New Zealand |
| Participants: |
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| Randomisation: | Clusters (PD units) randomised 1:1 to:
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| Primary Outcome: | Time to first PD-related infection (exit site infection, tunnel infection, or peritonitis) |
| Secondary Outcomes: |
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| Follow-up: |
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| Data Sources: |
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| Protocol Compliance: | Developed in accordance with SPIRIT guidelines |
References
Chow, J.S.F., Boudville, N., Cho, Y. et al. Multi-center, pragmatic, cluster-randomized, controlled trial of standardized peritoneal dialysis (PD) training versus usual care on PD-related infections (the TEACH-PD trial): trial protocol. Trials 24, 730 (2023). https://doi.org/10.1186/s13063-023-07715-0
Collaborators
Funding
TEACH‑PD is supported by a combination of government, industry, and philanthropic funding.
- Medical Research Future Fund (MRFF) — $2.38 million awarded in 2019 under the Rare Cancers, Rare Diseases and Unmet Clinical Need Clinical Trials Program (Australia)
- Health Research Council of New Zealand — $1.43 million awarded over five years (New Zealand)
- Additional support from:
- Queensland Government
- Metro South Health Research Support Scheme
- Baxter Healthcare
- BEAT‑CKD Program
- International Society for Peritoneal Dialysis, whose grant supported trial initiation and leveraged further funding
Collaborators
- The HOME Network (THN)
- Australia and New Zealand Dialysis and Transplant Registry (ANZDATA)
- New Zealand Peritoneal Dialysis Registry (NZPD)
- Australasian Kidney Trials Network (AKTN)
Contact Us
ANZDATA Coordinator: Lavern Greenham, Email: trials@anzdata.org.au
Phone: (08) 8128 4758
Ethics approval
South Western Sydney Local Health District Human Research Ethics Committee – EC00136
HREC/19/LPOOL/32
HREC Chair: Professor Murray Killingsworth (Chair)
Email: SWSLHD-Ethics@health.nsw.gov.au
Phone: (02) 8738 8304