A Virtual Post-Discharge Intervention to Prevent Hospital Re-Admissions in Patients With CKD
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Chronic Kidney Diseases
- Sponsor
- McMaster University
- Enrollment
- 30
- Primary Endpoint
- Patient uptake of the intervention
- Status
- Not Yet Recruiting
- Last Updated
- last year
Overview
Brief Summary
This pilot, interventional study is testing a combination of remote, virtual interventions, delivered to patients at home to patients with chronic kidney disease (CKD), with the goal of reducing admissions to hospital.
Detailed Description
Chronic kidney disease and kidney failure increase the risk of hospitalizations. Many hospital admissions are potentially avoidable. This pilot, interventional study is testing a combination of remote, virtual interventions, delivered to patients at home, with the goal of reducing admissions to hospital. The hypothesis for this pilot work is that the proposed interventions will be adopted by patients and will improve mental health, physical function, quality of life, and disease self-management, which are all key potential mediators of hospital readmission risk in patients with chronic kidney disease.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Adults with CKD (defined as an estimated glomerular filtration rate \<30mL/min/1.73m2, including hemodialysis)
- •Able to provide informed consent.
- •Ongoing follow-up by the St Joseph's Hospital Hamilton Kidney Care Clinic or Dialysis Program and with a recent hospital admission.
Exclusion Criteria
- •Unable to speak or understand English.
- •Significant cognitive impairment (as per the treating inpatient care team)
- •Serious mental illness (schizophrenia, severe untreated bipolar disorder, psychosis, active suicidal ideation)
- •Significant vision or hearing impairment that prevents use of the technology or participation in any of the intervention components.
- •Being discharged to long-term care, rehab or complex care.
- •Peritoneal dialysis
- •Home hemodialysis
- •Functioning kidney transplant
Outcomes
Primary Outcomes
Patient uptake of the intervention
Time Frame: 10 weeks
Patient use of the Aetonix platform and virtual intervention components. Uptake of the virtual CBT intervention will be determined by the number of attended sessions.
Patient acceptance of the intervention
Time Frame: 10 weeks
Acceptability of the technology will be determined by the proportion of patients who provide a mean Telehealth Usability Questionnaire (TUQ) score \>5/7. The mean TUQ score ranges from 1 to 7, with a higher score indicating greater acceptance of the intervention.
Secondary Outcomes
- Change in disease self-efficacy(10 weeks)
- Change in overall self-reported health(10 weeks)
- Uptake of systolic and diastolic blood pressure monitoring(10 weeks)
- Change in depression(10 weeks)
- All-cause hospitalizations(10 weeks)
- Patients' reasons for not participating in virtual sessions.(10 weeks)
- Patient satisfaction with the intervention(Measured at 10 weeks (study end))
- Changes in management as a result of remote monitoring(10 weeks)
- Change in anxiety(10 weeks)
- Questionnaire completion(10 weeks)
- Emergency room visits(10 weeks)
- Change in self-reported quality of life(10 weeks)