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Evaluation of the Optimal Transition Program

Conditions
Hemodialysis
ESRD
Interventions
Other: Analysis using descriptive statistics of patient clinical outcomes.
Other: Surveys with participants using validated survey tools.
Other: Evaluation of the program process including time, costs, referral rates, admission to the program and length of stay.
Registration Number
NCT04263233
Lead Sponsor
Satellite Healthcare
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.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
20
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

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
OtherEvaluation of the program process including time, costs, referral rates, admission to the program and length of stay.This program, which is provided for all patients new to dialysis at the participating units, will be evaluated by assessing patient clinical outcomes and the results of surveys measuring patient-reported symptoms, quality of life, knowledge and activation. In addition, satisfaction with the program will be assessed.
OtherAnalysis using descriptive statistics of patient clinical outcomes.This program, which is provided for all patients new to dialysis at the participating units, will be evaluated by assessing patient clinical outcomes and the results of surveys measuring patient-reported symptoms, quality of life, knowledge and activation. In addition, satisfaction with the program will be assessed.
OtherSurveys with participants using validated survey tools.This program, which is provided for all patients new to dialysis at the participating units, will be evaluated by assessing patient clinical outcomes and the results of surveys measuring patient-reported symptoms, quality of life, knowledge and activation. In addition, satisfaction with the program will be assessed.
Primary Outcome Measures
NameTimeMethod
Evaluation of clinical stabilization through standard clinical dialysis labsOn 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 measurementsAt 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 pressuresAt 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 ultrafiltrationAt 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 weightAt 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 measurementsAt 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 educationWeek 1 and Week 4

Survey of patient experience

Type of Dialysis Modality chosen by the patientWeek 1 and Week 4

Dialysis modality choice as reported by the patient

Actual Type of Dialysis Modality used by the patientweek 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 modalitiesWeek 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 activationWeek 3 and month 3

Survey measuring patient activation (PAM-13) survey

Evaluation of patient satisfactionWeek 4 or discharge from the program whichever comes first

Survey of satisfaction with the program

Evaluation of the program process for time utilizationWeek 1 through week 4

Time per patient for visits from program start to completion for each patient

Evaluation of the program process for cost utilizationWeek 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 programWeek 1 through week 4

Number of referrals to the program and subsequent number of admissions to the program.

Evaluation of the program efficiencyWeek 1 through week 4

Average length of stay for each patient in the program.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (3)

Satellite Healthcare Oakland

🇺🇸

Oakland, California, United States

Satellite Healthcare Chickasaw Gardens

🇺🇸

Memphis, Tennessee, United States

Satellite Healthcare Sacramento

🇺🇸

Sacramento, California, United States

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