ESRD, Hemodialysis
Conditions
Keywords
ESRD, Hemodialysis, Education, Evaluation
Brief summary
This is an evaluation of a program developed by a team of nephrologists, operations experts and researchers. The goal is to provide CKD patients with a better way to transition to life on dialysis - one that emphasizes even more individual clinical, psychosocial and lifestyle needs. On top of high-quality clinical care, the 4-week Optimal Transition program supports patients as they adjust to treatment and learn to live the best life possible. This is done through a robust education curriculum and a trust-building approach.
Detailed description
In this program evaluation the investigators will be reporting on the following program outcomes: 1. Clinical and psychosocial stabilization: to include lab values, clinical dialysis parameters, patient-reported symptoms, quality of life, hospitalization and mortality rates. 2. Dialysis modality choice with satisfaction with the modality education and continued modality use over 24 months. 3. Patient knowledge, activation, and satisfaction. 4. Program parameters such as time, costs, referral rate, admissions and length of stay within the program.
Interventions
OTHERAnalysis using descriptive statistics of patient clinical outcomes.
Evaluation of the following: * Laboratory values at admission, week 4, and day 90. * Pre and post blood pressure at week one and week 4. * Intradialytic hypotension at week one and week 4. * Ultrafiltration rates at week one, week 4, day 90, day 180, and day 360. * Target weight defined and achievement in week one and week 4 and changes between week one and week 4. * Dialysis access type at week one and day 90. * Hospitalization and mortality rates.
OTHERSurveys with participants using validated survey tools.
Surveys will assess participants' Symptom index, Quality of Life, Patient Activation as well as satisfaction with the program.
OTHEREvaluation of the program process including time, costs, referral rates, admission to the program and length of stay.
Data will be collected using tracking tools throughout the program.
Sponsors
Satellite Healthcare
Study design
Observational model
OTHER
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Referred for incenter hemodialysis at one of two Satellite Healthcare (SHC) participating dialysis units * Without significant cognitive impairment; * Able to meaningfully interact with staff; and * Fluent in English (due to education material being limited to English at this time).
Exclusion criteria
* Unable to meaningfully interact with staff; * Unable to read and understand English; or * Has significant cognitive impairment per the nephrologist or Principal Investigator
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evaluation of clinical stabilization through standard clinical dialysis labs | On admission, week 4 and day 90 | Evaluation of changes in the Standard of care monthly dialysis labs |
| Evaluation of clinical stabilization through standard clinical dialysis blood pressure measurements | At week one and week 4. | Evaluation of any changes in the Pre and post dialysis blood pressures for each patient which are collected as part of the patient's dialysis flow sheet. |
| Evaluation of clinical stabilization through standard clinical dialysis measurements of Intradialytic blood pressures | At week one and week 4. | Evaluation of any changes in the incidence of Intradialytic hypotension as assessed by review of the patient's dialysis flow sheet. |
| Evaluation of clinical stabilization through standard clinical dialysis measurements of ultrafiltration | At week one, week 4, day 90, day 180 and day 360. | Evaluation of interval changes in the patient's ultrafiltration rates as measured by the dialysis machine and reported on the patient's dialysis flow sheets. |
| Evaluation of clinical stabilization through standard clinical dialysis measurements of weight | At week one and week 4, and changes between week one and week 4. | Target weight defined and achieved as measured by standard of care at the unit |
| Evaluation of clinical stabilization through standard clinical dialysis measurements | At week one and day 90 | Dialysis access type as reported in the dialysis treatment sheets |
| Evaluation of clinical stabilization through standard clinical dialysis collection of patient hospitalizations. | Day 30, day 90, 6 months and 12 months | Hospitalization rates as reported in the standard dialysis record for all patients |
| Evaluation of clinical stabilization through standard clinical dialysis records. | Day 30, day 90, 6 months and 12 months | Mortality rates as reported in the standard dialysis record for all patients |
| Evaluation of clinical and psychological stabilization through a quality of life measurement. | Week 4 | The EQ-5D tool will be used |
| Evaluation of clinical and psychological stabilization through assessment of patient symptoms. | Week 1 and Week 4 | The ESAS-r:Renal tool will be used |
| Satisfaction with the modality options education | Week 1 and Week 4 | Survey of patient experience |
| Type of Dialysis Modality chosen by the patient | Week 1 and Week 4 | Dialysis modality choice as reported by the patient |
| Actual Type of Dialysis Modality used by the patient | week 4, month 3, 6, 12, 18 and 24 | Dialysis modality as reported on the standard dialysis treatment sheets |
| Evaluation of patient knowledge of dialysis and modalities | Week 1, 2, 3, 4 | Weekly focused one on one discussion where the patient is questioned about his/her understanding of dialysis, his/her progress, questions, concerns using a questionnaire developed by the investigator |
| Evaluation of patient activation | Week 3 and month 3 | Survey measuring patient activation (PAM-13) survey |
| Evaluation of patient satisfaction | Week 4 or discharge from the program whichever comes first | Survey of satisfaction with the program |
| Evaluation of the program process for time utilization | Week 1 through week 4 | Time per patient for visits from program start to completion for each patient |
| Evaluation of the program process for cost utilization | Week 1 through week 4 | Time, and thus cost, for personnel to complete the program with each patient from entrance to completion or early termination. |
| Evaluation of the feasibility of the program | Week 1 through week 4 | Number of referrals to the program and subsequent number of admissions to the program. |
| Evaluation of the program efficiency | Week 1 through week 4 | Average length of stay for each patient in the program. |
Countries
United States
Contacts
Primary ContactJug Atwal
Backup ContactLegg Veronica, M.S.
Outcome results
None listed