Annie-Claire Nadeau-Fredette1, Christopher T Chan2, Joanne M Bargman2, Michael A Copland3, S Neil Finkle4, Matthew J Oliver5, Robert P Pauly6, Jeffrey Perl7, Nikhil A Shah6, Deborah L Zimmerman8, Karthik K Tennankore4. 1. Hopital Maisonneuve-Rosemont and Research Center, Montreal, Québec, Canada, ac.nadeau-fredette@umontreal.ca. 2. University Health Network/Toronto General Hospital, Toronto, Ontario, Canada. 3. University of British Columbia, Vancouver, British Columbia, Canada. 4. Dalhousie University/Nova Scotia Health Authority, Halifax, Nova Scotia, Canada. 5. Sunnybrook Health Sciences Center, Toronto, Ontario, Canada. 6. University of Alberta, Edmonton, Alberta, Canada. 7. St. Michael's Hospital, Toronto, Ontario, Canada. 8. The Ottawa Hospital, Ottawa, Ontario, Canada.
Abstract
BACKGROUND: Home dialysis patients may be at an increased risk of adverse events after transitional states. The home dialysis virtual ward (HDVW) trial was conducted in Canadian dialysis centers and aimed to evaluate potential care gaps and patient satisfaction during the HDVW. METHODS: The HDVW was a multicenter single-arm trial including peritoneal dialysis and home hemodialysis patients after 4 different events (hospital discharge, medical procedure, antibiotics, completion of training). Telephone-led interviews using a standardized assessment tool were performed over a 2-week period to assess a patient's care and adjust treatment as required. Upon completion, patients were surveyed to evaluate their perceived impact on domains of care using a rating scale; 1 not satisfied to 10 completely satisfied. RESULTS: The HDVW trial included 193 patients with a median number of potential care gaps/interventions of 1 (0-2) per patient. Patients admitted to the HDVW after hospital discharge were at a higher risk of potential gaps in care (OR 2.16, 95% CI 1.29-3.62), while longer dialysis vintage was -associated with a lower number of gaps/interventions (OR 0.97 per year, 95% CI 0.95-0.98). A total of 105/193 (54%) patients completed satisfaction surveys. Patients were highly satisfied with the HDVW (median rating scale score 8, IQR 2) and felt it had a positive impact (rating scale score ≥7) on their overall health, understanding of treatment and access to a nephrologist. CONCLUSION: The HDVW was effective at identifying several potential care gaps, and patients were satisfied across several domains of care. This intervention may be valuable in supporting home dialysis patients during care transitions.
BACKGROUND: Home dialysis patients may be at an increased risk of adverse events after transitional states. The home dialysis virtual ward (HDVW) trial was conducted in Canadian dialysis centers and aimed to evaluate potential care gaps and patient satisfaction during the HDVW. METHODS: The HDVW was a multicenter single-arm trial including peritoneal dialysis and home hemodialysis patients after 4 different events (hospital discharge, medical procedure, antibiotics, completion of training). Telephone-led interviews using a standardized assessment tool were performed over a 2-week period to assess a patient's care and adjust treatment as required. Upon completion, patients were surveyed to evaluate their perceived impact on domains of care using a rating scale; 1 not satisfied to 10 completely satisfied. RESULTS: The HDVW trial included 193 patients with a median number of potential care gaps/interventions of 1 (0-2) per patient. Patients admitted to the HDVW after hospital discharge were at a higher risk of potential gaps in care (OR 2.16, 95% CI 1.29-3.62), while longer dialysis vintage was -associated with a lower number of gaps/interventions (OR 0.97 per year, 95% CI 0.95-0.98). A total of 105/193 (54%) patients completed satisfaction surveys. Patients were highly satisfied with the HDVW (median rating scale score 8, IQR 2) and felt it had a positive impact (rating scale score ≥7) on their overall health, understanding of treatment and access to a nephrologist. CONCLUSION: The HDVW was effective at identifying several potential care gaps, and patients were satisfied across several domains of care. This intervention may be valuable in supporting home dialysis patients during care transitions.
Authors: Breda Cushen; Aisling Madden; Deirdre Long; Yvonne Whelan; Michael Emmet O'Brien; Deirdre Carroll; Des O'Flynn; Michelle Forde; Virginia Pye; Loretto Grogan; Margaret Casey; Karolina Farrell; Richard W Costello; Clare Lewis Journal: Ir J Med Sci Date: 2021-05-06 Impact factor: 2.089
Authors: Bailey Paterson; Danielle E Fox; Chel Hee Lee; Victoria Riehl-Tonn; Elena Qirzaji; Rob Quinn; David Ward; Jennifer M MacRae Journal: Can J Kidney Health Dis Date: 2021-06-13