Protection of peer mentorship to reduce hospitalization, ED visits varies by population
Click Here to Manage Email Alerts
Key takeaways:
- Rates of ED visits and hospitalizations were 0.17 per patient-month in the intervention group.
- Rates of ED visits and hospitalizations were 0.20 per patient-month in the usual care group.
PHILADELPHIA — The protective effect of peer mentorship to reduce hospitalizations and ED visits in patients on maintenance dialysis may be population-specific, according to a study presented at ASN Kidney Week.
“Peer mentorship should be used more often to improve support for patients. But peer mentorship training should be culturally sensitive, and training of mentors should be bidirectional: leaving room for the patient participants to contribute to design and sustainability of a patient-centered intervention,” Ladan Golestaneh MD, MS, professor of medicine at Albert Einstein College of Medicine/Montefiore Medical Center, told Healio.
The PEER-HD Trial is a multicenter, randomized controlled trial that tested the impact of a peer mentorship program on the number of ED visits and hospitalization rates for patients on hemodialysis. Overall, 194 patient-participants were studied, with 134 patients located in the Bronx borough of New York and 60 patients in Nashville.
Golestaneh and colleagues recruited and trained 14 mentors and matched 99 patients to mentors. Baseline characteristics were similar between groups, with mean age of 51.7 years and 51.5% female. Overall, 56.2% of patients self-identified as Black and 39.2% self-identified as Hispanic. During a 3-month period, the mentors called their mentees weekly and patients were observed for up to 15 months. Researchers recorded the number of per patient composite events during a 12-month median follow-up.
Researchers found rates of ED visits and hospitalizations as 0.17 per patient-month in the intervention group compared with 0.20 per patient-month in the usual care group. In the Bronx, New York setting, researchers found a significantly lower rate of outcome for patients in the intervention group compared with patients in usual care. In the Nashville site, researchers found no significantly different primary outcome.
“We were surprised by the effectiveness of the intervention in Bronx, New York. We had difficulty enrolling participants because of the disruptions caused by the COVID-19 pandemic and because of the adverse social determinants of health our patients face every day. We were surprised by how enthusiastic and generous our mentors were with their time and their energy,” Golestaneh said.
Golestaneh said the researchers hope to be able to use this model of care in other centers.
Collapse
Read more about
Click Here to Manage Email Alerts