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Collaboration in CKD care model helps reduce episodes of ‘crash’ dialysis
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HUNTINGTON BEACH, Calif. — Preliminary results from a pilot study presented here showed that educating patients with advanced chronic kidney disease about the upcoming signs of kidney failure can slow its progression and help reduce the risk of “crash” dialysis.
The study, a collaboration between Good Samaritan Hospital in Corvallis, Oregon, and Cricket Health, a kidney care provider that focuses on managing chronic kidney disease and ESRD, enlisted 250 patients to determine if they would become more engaged in managing their disease.
Jackie Chandler, RN, BA, CNN, director of dialysis at Good Samaritan, said the dialysis center was seeing too many patients starting dialysis in the emergency room.
“We needed to educate patients about a multidisciplinary approach to treating kidney disease earlier and avoid crashes onto dialysis,” she told Healio/Nephrology.
Chandler’s patients with CKD were in rural communities in midWillamette Valley in Oregon and came from 18 cities and three counties. Overall, approximately 250 patients in five dialysis facilities were tested. One of the five hospitals that managed the clinics provided nephrology care.
CKD education had been provided previously by large dialysis organizations, and patients typically received 2 to 4 hours of treatment. One licensed nurse practitioner was assigned to cover education for nine to 10 dialysis facilities.
In her talk, Dianna Budgeon, RN, of Cricket Health, said the provider incorporates an approach that is comprehensive, continuous and collaborative. The collaborative focus includes a multidisciplinary approach, as well as holistic care and education.
Patients enrolled in the study averaged 67 years old; 77% were retired, unemployed or on disability. Among the group, 57% had diabetes and 30% had been diagnosed with congestive heart failure.
“We compared confidence and self-efficacy before and after engaging in this care model,” Budgeon said.
Preliminary results showed after 32 days (on average) of providing education, 80% of patients with advanced CKD increased their view on self-efficacy; 76% showed increased knowledge about kidney disease and 60% showed increased confidence, Budgeon said. Results from the pilot study also showed 71% of patients had an interest in home dialysis, of which 43% initiated home therapy and 64% of the study group had a permanent access placed. –by Mark E. Neumann
Reference:
Chandler J and Budgeon D. Tools for success: Impacting chronic kidney disease outcomes. Presented at: National Renal Administrators Association Annual Conference; Oct. 2-4, 2019; Huntington Beach, California.