Dataset Information

Rationale for a home dialysis virtual ward: design and implementation.

ABSTRACT:

Background

Home-based renal replacement therapy (RRT) [peritoneal dialysis (PD) and home hemodialysis (HHD)] offers independent quality of life and clinical advantages compared to conventional in-center hemodialysis. However, follow-up may be less complete for home dialysis patients following a change in care settings such as post hospitalization. We aim to implement a Home Dialysis Virtual Ward (HDVW) strategy, which is targeted to minimize gaps of care.

Methods/design

The HDVW Pilot Study will enroll consecutive PD and HHD patients who fulfilled any one of our inclusion criteria: 1. following discharge from hospital, 2. after interventional procedure(s), 3. prescription of anti-microbial agents, or 4. following completion of home dialysis training. Clinician-led telephone interviews are performed weekly for 2 weeks until VW discharge. Case-mix (modified Charlson Comorbidity Index), symptoms (the modified Edmonton Symptom Assessment Scale) and patient satisfaction are assessed serially. The number of VW interventions relating to eight pre-specified domains will be measured. Adverse events such as re-hospitalization and health-services utilization will be ascertained through telephone follow-up after discharge from the VW at 2, 4, 12 weeks. The VW re-hospitalization rate will be compared with a contemporary cohort (matched for age, gender, renal replacement therapy and co-morbidities). Our protocol has been approved by research ethics board (UHN: 12-5397-AE). Written informed consent for participation in the study will be obtained from participants.

Discussion

This report serves as a blueprint for the design and implementation of a novel health service delivery model for home dialysis patients. The major goal of the HDVW initiative is to provide appropriate and effective supports to medically complex patients in a targeted window of vulnerability.

Trial registration

(NCT01912001).

SUBMITTER: Schachter ME

PROVIDER: S-EPMC3930556 | biostudies-literature | 2014 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Rationale for a home dialysis virtual ward: design and implementation.

Schachter Michael E ME Bargman Joanne M JM Copland Michael M Hladunewich Michelle M Tennankore Karthik K KK Levin Adeera A Oliver Matthew M Pauly Robert P RP Perl Jeffrey J Zimmerman Deborah D Chan Christopher T CT

BMC nephrology 20140214

<h4>Background</h4>Home-based renal replacement therapy (RRT) [peritoneal dialysis (PD) and home hemodialysis (HHD)] offers independent quality of life and clinical advantages compared to conventional in-center hemodialysis. However, follow-up may be less complete for home dialysis patients following a change in care settings such as post hospitalization. We aim to implement a Home Dialysis Virtual Ward (HDVW) strategy, which is targeted to minimize gaps of care.<h4>Methods/design</h4>The HDVW P ...[more]

PMID: 24528505

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Dataset Information

Rationale for a home dialysis virtual ward: design and implementation.

Background

Methods/design

Discussion

Trial registration

Publications

Rationale for a home dialysis virtual ward: design and implementation.

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