Effectiveness of adherence to a renal health program in a health network in Peru
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. Adhere...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Universidade de São Paulo
2020-08-01
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| Series: | Revista de Saúde Pública |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102020000100259&tlng=en |
| _version_ | 1819261039718432768 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Jessica Bravo-Zúñiga |
| collection | DOAJ |
| description | 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 total of 20,354 participants was evaluated; 54.1% were male, 72.1 years old in 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. |
| first_indexed | 2024-12-23T19:35:28Z |
| format | Article |
| id | doaj.art-355aa880344a4867bdb90dc88e35b972 |
| institution | Directory Open Access Journal |
| issn | 1518-8787 |
| language | English |
| last_indexed | 2024-12-23T19:35:28Z |
| publishDate | 2020-08-01 |
| publisher | Universidade de São Paulo |
| record_format | Article |
| series | Revista de Saúde Pública |
| spelling | doaj.art-355aa880344a4867bdb90dc88e35b9722022-12-21T17:33:48ZengUniversidade de São PauloRevista de Saúde Pública1518-87872020-08-015410.11606/s1518-8787.2020054002109Effectiveness of adherence to a renal health program in a health network in PeruJessica Bravo-Zúñigahttps://orcid.org/0000-0003-2528-6271Enrique M. Saldarriagahttps://orcid.org/0000-0001-8879-6354Ricardo Chávez-Gómezhttps://orcid.org/0000-0003-4919-0098Jungmei Gálvez-Ingahttps://orcid.org/0000-0001-5992-6877Renzo Valdivia-Vegahttps://orcid.org/0000-0002-8718-4361Mirko Villavicencio-Carranzahttps://orcid.org/0000-0001-7262-4072José Espejo-Sotelohttps://orcid.org/0000-0003-3883-1750Carola Medina-Sal y Rosashttps://orcid.org/0000-0001-8269-3231Víctor Suarez-Morenohttps://orcid.org/0000-0002-7078-4731Yamilee Hurtado-Rocahttps://orcid.org/0000-0001-5910-6334ABSTRACT 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 total of 20,354 participants was evaluated; 54.1% were male, 72.1 years old in 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102020000100259&tlng=enChronic Renal Insufficiency, prevention & controlDelivery of Health Care, IntegratedInterdisciplinary CommunicationEvaluation of the Efficacy-Effectiveness of Interventions |
| spellingShingle | 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 Effectiveness of adherence to a renal health program in a health network in Peru Revista de Saúde Pública Chronic Renal Insufficiency, prevention & control Delivery of Health Care, Integrated Interdisciplinary Communication Evaluation of the Efficacy-Effectiveness of Interventions |
| title | Effectiveness of adherence to a renal health program in a health network in Peru |
| title_full | Effectiveness of adherence to a renal health program in a health network in Peru |
| title_fullStr | Effectiveness of adherence to a renal health program in a health network in Peru |
| title_full_unstemmed | Effectiveness of adherence to a renal health program in a health network in Peru |
| title_short | Effectiveness of adherence to a renal health program in a health network in Peru |
| title_sort | effectiveness of adherence to a renal health program in a health network in peru |
| topic | Chronic Renal Insufficiency, prevention & control Delivery of Health Care, Integrated Interdisciplinary Communication Evaluation of the Efficacy-Effectiveness of Interventions |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102020000100259&tlng=en |
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