Education, combined with an integrated patient and provider online community, increases the likelihood that people with late-stage chronic kidney disease (CKD) opt for at-home dialysis, pre-emptive transplant or palliative care instead of going to a hemodialysis center.
Cricket Health reported these findings during the April 18-22 National Kidney Foundation Spring Clinical Meetings in Orlando, Fla.
San Francisco-based Cricket Health developed a 30- to 60-day online program, called Modality Choice, for patients with advanced CKD to learn end-stage renal disease (ESRD) treatment options led by a “virtual clinical care team” that includes nurses and patient mentors. The company then evaluated patients’ choice of treatment after completing the program.
The study enrolled 27 patients with CKD stages 3b, 4, and 5 being treated at one of four California nephrology practices. Results showed that, after the educational program, 19 patients (70 percent) were able to make a choice regarding treatment and management options.
Seventeen of these 19 patients, or 89.5 percent, opted for at-home dialysis, while 18, or 95 percent, expressed interest in being evaluated for a kidney transplant. Three of the 27 were unable to decide on a preferred treatment after completing the program, and five others are still taking part in the educational program.
About 34 days are needed for a patient to make a decision, the researchers reported.
“We found that if patients are well-informed and receive timely information and support, most will choose some form of home dialysis over center-based hemodialysis,” Dr. Anna Malkina, a nephrologist with the University of California-San Francisco and medical director for Cricket Health, said in a news release.
Patients diagnosed with late-stage CKD or ESRD, which affects about 20 million Americans, are thrown into a healthcare management system with a lack of education and care coordination, the company says, and often offered expensive treatment options like in-center dialysis, which also fail to account for patient’s values and lifestyle routines.
Said company CEO Arvind Rajan: “At Cricket Health, we believe the entire model for managing chronic kidney disease needs to be turned on its head.”