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Telemedicine for Outpatient Care of Kidney Transplant and CKD Patients

机译:肾移植和CKD患者门诊治疗的远程医疗

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IntroductionTelehealth videoconferencing (TVC) may improve access in rural areas, but reported uptake and outcomes among kidney transplant recipients (KTRs) and chronic kidney disease (CKD) patients are limited. This study aimed to assess the feasibility, sustainability, and clinical outcomes of TVC for this patient population.MethodsA total of 64 participants were recruited in this single-center, prospective, 2-year longitudinal, case-control study. Inclusion criteria for the telemedicine group included travel of?≥15 km to the hospital, and the control group was matched for transplant or CKD status, age, and sex. The primary outcome was feasibility (≥50% of consultations for each individual patient in the telemedicine group being conducted by TVC in year 1). Secondary outcomes were sustainability of telemedicine, change in blood pressure and creatinine, hospitalization, and travel distance.ResultsThere were 32 participants in both the telemedicine and control arms, with no baseline differences. The majority were male (65.6%) and the mean age was 63.9 years (SD?= 12.3 years). TVC uptake in year 1 in the telemedicine arm was 71% (interquartile range [IQR]?= 50.0?100.0) but reduced significantly in year 2 (50.0% [IQR?= 33.3?71.4],P?< 0.01). No significant differences in creatinine or blood pressure were observed between groups, including in the KTRs and CKD subgroup analysis. Patient satisfaction remained high for both groups. Compared with travel distance required if TVC was unavailable, travel distance in the TVC group decreased by 48% (16,644 km) in year 1 and by 37.0% (8177 km) in year?2.ConclusionTVC was feasible and sustainable, with outcomes comparable to those of standard care. Larger studies, especially among KTRs, are needed to confirm these findings.
机译:引入延迟录像机(TVC)可能会改善农村地区的访问,但报告肾移植受者(KTRS)和慢性肾病(CKD)患者的摄取和结果受到限制。本研究旨在评估这种患者群体的可行性,可持续性和临床结果。在这项单一中心,前瞻性,2年纵向,案例控制研究中招募了64名参与者的64名参与者。纳入近距离集团的纳入标准包括+ 21公里到医院的旅行,对照组匹配移植或CKD状态,年龄和性别。主要结果是可行性(≥50%的患者在第1年度通过TVC进行的远程医疗组中的每个患者的咨询≥50%)。二次结果是远程医疗的可持续性,血压和肌酐,住院和旅行距离的变化。渗透液和控制臂中的32名参与者,没有基线差异。大多数是男性(65.6%),平均年龄为63.9岁(SD?= 12.3岁)。 TVC在远程医疗臂中的1年度吸收量为71%(句子范围[IQR]?= 50.0?100.0),但在2年内显着减少(50.0%[IQR?= 33.3?71.4],P?<0.01)。在基团之间没有观察到肌酐或血压的显着差异,包括在KTR和CKD亚组分析中。两组患者满意度仍然很高。与旅行距离相比,如果TVC不可用,TVC集团的旅行距离在1年级减少了48%(16,644公里),同比下降37.0%(8177公里)?2.ConclusionTVC是可行和可持续的,结果可与标准护理的人。需要较大的研究,特别是在KTR中,需要确认这些发现。

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