Effectiveness of adherence to a renal health program in a health network in Peru

Jessica Bravo-Zúñiga, Enrique M. Saldarriaga, Ricardo Chávez-Gómez, Jungmei Gálvez-Inga, Renzo Valdivia-Vega, Mirko Villavicencio-Carranza, José Espejo-Sotelo, Carola Medina Sal y Rosas, Víctor Suarez-Moreno, Yamilee Hurtado-Roca

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Abstract

OBJECTIVE: To evaluate the effectiveness of adherence to a multidisciplinary renal health program in reducing mortality and progression to hemodialysis. METHODS: We used a database that included patient monitoring (2013-2017), dialysis admissions and all cause of mortality in Peru. Adherence to the program was established by meeting minimum visits during the first year of monitoring. The outcome of interest was hemodialysis admissions or all cause-mortality. Kaplan-Meier curves, Log-Rank test and competing survival analysis methods were used to estimate the differential risk between adherent and non-adherent patients. RESULTS: A t otal of 2 0,354 p articipants w as e valuated; 5 4.1% w ere m ale, 7 2.1 y ears o ld i n average, 2.2 years average follow-up, and 15,279 (75.1%) belonged to the early stages (1 to 3a) of Chronic Kidney Disease. Adherence decreased the risk of renal replacement therapy in 41.0% (HR = 0.59, 95%CI 0.41-0.85) in the low-risk group and mortality in the high-risk group was 31.0% (HR = 0.69, 95%CI 0.57-0.83). CONCLUSIONS: The multidisciplinary care strategy with standardized assessments by stage is effective in reducing admission to.0when the patient is identified in early stages and in reducing mortality in advanced stages.

Original languageEnglish
Article number80
JournalRevista de Saude Publica
Volume54
DOIs
StatePublished - 2020

Keywords

  • Chronic renal insufficiency
  • Delivery of health care
  • Evaluation of the efficacy-effectiveness of interventions
  • Integrated
  • Interdisciplinary communication
  • Prevention and control

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