Remote care technologies are valuable in providing high-quality, individual care to patients with chronic kidney disease (CKD), especially for those who live a distance from a treatment facility, according to the results of a study presented during the ASN Kidney Week 2015, held Nov. 3–8 in San Diego, California.
The study, led by Rajeev Rohatgi, MD, FASN, showed that using telemedicine to remotely deliver care to CKD patients with via telenephrology (videoconferencing) is equivalent to standard in-person care, and may even be superior for visit compliance. As Dr. Rohatgi noted, evidence indicates that patients with CKD who live far from a nephrology clinical practice have higher hospitalization rates as well as higher rates of mortality compared to CKD patients living near one.
In the retrospective observational study, investigators evaluated the clinical outcomes of 121 CKD patients living close to and enrolled at the Bronx Veterans Affairs Medical Center (VAMC) clinic. These subjects were compared to a group of 117 CKD patients living a distance from a VA nephrologist practice and enrolled in telenephrology sessions. A nephrologist located at the Bronx VAMC remotely evaluated the study subjects between 2008 and 2014.
Results revealed that kidney disease characteristics were identical between the two groups, including eGRF, initial creatinine, distribution of CKD stage, and urine protein. However, the team found that the telenephrology group of patients had better appointment attendance (70.8%) compared to the standard care group (61.8%) and, subsequently, fewer canceled appointments (15.8% to 27.9%, respectively). Results further showed that before the institution of a telenephrology service, over 50% of CKD patients living far from a VA nephrologist either missed or canceled appointments at the Bronx VAMC. However, after establishing a telenephrology service, the rate of missed or canceled appointments was reduced by nearly half.
The team believes that care given to CKD patients locally increases the probability that they will attend their appointments, leading to clinical outcomes identical to conventional care. “These data imply that remote delivery of care via telenephrology has the potential to deliver equitable, patient-centered care to a geographically diverse patient population, while alleviating disparity in care,” Dr. Rohatgi said in a news release.