Group-based care seen as alternative to usual nephrology care alone for CKD management
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Group-based care for the management of chronic kidney disease may be a promising alternative to usual nephrology care alone in adult patients, according to findings in a recently published study.
“Studies show that blood pressure is often poorly controlled and low medication adherence is common in the chronic kidney disease (CKD) population ... Adherence involves a complex interplay of patient, condition, therapy, provider and environmental factors,” Tanya S. Johns, MD, MHS, of Albert Einstein College of Medicine, Montefiore Medical Center, and colleagues wrote. “Group-based care, a newer model of health care delivery, provides an opportunity to increase patient access to providers without increasing physician hours.”
In a randomized control trial to determine the feasibility of group-based care vs. nephrology care alone, patients with hypertension and CKD (50 adults older than 21 years and 10 adolescents) were analyzed between August 2014 and August 2017.
All patients were seen at baseline and 6 months. In addition, patients in the group-based care cohort were seen once a month. The primary clinical outcome was change in mean blood pressure. Secondary outcomes included medication adherence, quality of life and sodium intake.
Study outcomes showed the adult group-based care cohort (26 patients) reported higher satisfaction with their care, as well as a 4.2 mmHG decrease in ambulatory systolic blood pressure at 6 months compared to the adult nephrology care cohort (24 patients). No significant difference in health-related behaviors, such as medication adherence and sodium intake, and quality of life measures were found between the cohorts.
“Our study findings indicate that group-based care is feasible and may be a promising alternative to usual nephrology care alone in adult patients with CKD,” Johns and colleagues concluded. “However, larger studies are needed to determine its effect on blood pressure management and health-related behaviors.” – by Kate Burba
Disclosures: Johns reports no relevant financial disclosures. Please see the study for all other authors’ disclosures.
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Johns TS, et al. Kidney Medicine. 2020;doi:10.1016/j.xkme.2020.01.013.
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