Acute Kidney Injury Survivor Remote Patient Monitoring: A Single Center’s Experience and an Effectiveness Evaluation
Rationale & Objective: Remote patient monitoring (RPM) could improve the quality and efficiency of acute kidney injury (AKI) survivor care. This study described our experience with AKI RPM and characterized its effectiveness. Study Design: A cohort study matched 1:3 to historical controls. S...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-11-01
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| Series: | Kidney Medicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S259005952400116X |
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| author | Mariam Charkviani Andrea G. Kattah Andrew D. Rule Jennifer A. Ferguson Kristin C. Mara Kianoush B. Kashani Heather P. May Jordan K. Rosedahl Swetha Reddy Lindsey M. Philpot Erin F. Barreto |
| author_facet | Mariam Charkviani Andrea G. Kattah Andrew D. Rule Jennifer A. Ferguson Kristin C. Mara Kianoush B. Kashani Heather P. May Jordan K. Rosedahl Swetha Reddy Lindsey M. Philpot Erin F. Barreto |
| author_sort | Mariam Charkviani |
| collection | DOAJ |
| description | Rationale & Objective: Remote patient monitoring (RPM) could improve the quality and efficiency of acute kidney injury (AKI) survivor care. This study described our experience with AKI RPM and characterized its effectiveness. Study Design: A cohort study matched 1:3 to historical controls. Setting & Participants: Patients hospitalized with an episode of AKI who were discharged home and were not treated with dialysis. Exposure: Participation in an AKI RPM program, which included use of a home vital sign and symptom monitoring technology and weekly in-center laboratory assessments. Outcomes: Risk of unplanned hospital readmission or emergency department (ED) visit within 6 months. Analytic Approach: Endpoints were assessed using Cox proportional hazards models. Results: Forty of the 49 patients enrolled in AKI RPM (82%) participated in the program after hospital discharge. Seventy three percent of patients experienced one AKI RPM alert, most commonly related to fluid status. Among those with stage 3 AKI, the risk of unplanned readmission or ED visit within 6 months of discharge was not different between AKI RPM patients (n = 34) and matched controls (n = 102) (HR 1.33 [95% CI, 0.81-2.18]; P = 0.27). The incidence of an ED visit without hospitalization was significantly higher in the AKI RPM group (HR 1.95, [95% CI, 1.05-3.62]; P = 0.035). The risk of an unplanned readmission or ED visit was higher in those with baseline eGFR < 45 mL/min/1.73 m2 exposed to AKI RPM (HR 2.24 [95% CI, 1.19-4.20]; P = 0.012) when compared with those with baseline eGFR ≥45 mL/min/1.73 m2 (HR 0.69 [95% CI, 0.29-1.67]; P = 0.41) (test of interaction P = 0.04). Limitations: Small sample size that may have been underpowered for the effectiveness endpoints. Conclusions: AKI RPM, when used after hospital discharge, led to alerts and interventions directed at optimizing kidney health and AKI complications but did not reduce the risk for rehospitalization. |
| format | Article |
| id | doaj-art-b7f1a51f79ac4335814646bf4c6b3534 |
| institution | Kabale University |
| issn | 2590-0595 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney Medicine |
| spelling | doaj-art-b7f1a51f79ac4335814646bf4c6b35342024-11-17T04:52:29ZengElsevierKidney Medicine2590-05952024-11-01611100905Acute Kidney Injury Survivor Remote Patient Monitoring: A Single Center’s Experience and an Effectiveness EvaluationMariam Charkviani0Andrea G. Kattah1Andrew D. Rule2Jennifer A. Ferguson3Kristin C. Mara4Kianoush B. Kashani5Heather P. May6Jordan K. Rosedahl7Swetha Reddy8Lindsey M. Philpot9Erin F. Barreto10Division of Nephrology & Hypertension, Mayo Clinic, Rochester, MNDivision of Nephrology & Hypertension, Mayo Clinic, Rochester, MNDivision of Nephrology & Hypertension, Mayo Clinic, Rochester, MN; Division of Epidemiology, Mayo Clinic, Rochester, MNDivision of Community Internal Medicine, Mayo Clinic, Rochester, MNDepartment of Quantitative Health Sciences, Mayo Clinic, Rochester, MNDivision of Nephrology & Hypertension, Mayo Clinic, Rochester, MN; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MNDepartment of Pharmacy, Mayo Clinic, Rochester, MNDepartment of Quantitative Health Sciences, Mayo Clinic, Rochester, MNDivision of Critical Care Medicine, Department of Medicine, Mayo Clinic, Jacksonville, FL; Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Jacksonville, FLDivision of Epidemiology, Mayo Clinic, Rochester, MN; Division of Community Internal Medicine, Mayo Clinic, Rochester, MNDepartment of Pharmacy, Mayo Clinic, Rochester, MN; Address for Correspondence: Erin F. Barreto, PharmD, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, Minnesota, 55905.Rationale & Objective: Remote patient monitoring (RPM) could improve the quality and efficiency of acute kidney injury (AKI) survivor care. This study described our experience with AKI RPM and characterized its effectiveness. Study Design: A cohort study matched 1:3 to historical controls. Setting & Participants: Patients hospitalized with an episode of AKI who were discharged home and were not treated with dialysis. Exposure: Participation in an AKI RPM program, which included use of a home vital sign and symptom monitoring technology and weekly in-center laboratory assessments. Outcomes: Risk of unplanned hospital readmission or emergency department (ED) visit within 6 months. Analytic Approach: Endpoints were assessed using Cox proportional hazards models. Results: Forty of the 49 patients enrolled in AKI RPM (82%) participated in the program after hospital discharge. Seventy three percent of patients experienced one AKI RPM alert, most commonly related to fluid status. Among those with stage 3 AKI, the risk of unplanned readmission or ED visit within 6 months of discharge was not different between AKI RPM patients (n = 34) and matched controls (n = 102) (HR 1.33 [95% CI, 0.81-2.18]; P = 0.27). The incidence of an ED visit without hospitalization was significantly higher in the AKI RPM group (HR 1.95, [95% CI, 1.05-3.62]; P = 0.035). The risk of an unplanned readmission or ED visit was higher in those with baseline eGFR < 45 mL/min/1.73 m2 exposed to AKI RPM (HR 2.24 [95% CI, 1.19-4.20]; P = 0.012) when compared with those with baseline eGFR ≥45 mL/min/1.73 m2 (HR 0.69 [95% CI, 0.29-1.67]; P = 0.41) (test of interaction P = 0.04). Limitations: Small sample size that may have been underpowered for the effectiveness endpoints. Conclusions: AKI RPM, when used after hospital discharge, led to alerts and interventions directed at optimizing kidney health and AKI complications but did not reduce the risk for rehospitalization.http://www.sciencedirect.com/science/article/pii/S259005952400116XTelehealthdigital healthremote patient monitoringacute kidney injuryhealth technology |
| spellingShingle | Mariam Charkviani Andrea G. Kattah Andrew D. Rule Jennifer A. Ferguson Kristin C. Mara Kianoush B. Kashani Heather P. May Jordan K. Rosedahl Swetha Reddy Lindsey M. Philpot Erin F. Barreto Acute Kidney Injury Survivor Remote Patient Monitoring: A Single Center’s Experience and an Effectiveness Evaluation Kidney Medicine Telehealth digital health remote patient monitoring acute kidney injury health technology |
| title | Acute Kidney Injury Survivor Remote Patient Monitoring: A Single Center’s Experience and an Effectiveness Evaluation |
| title_full | Acute Kidney Injury Survivor Remote Patient Monitoring: A Single Center’s Experience and an Effectiveness Evaluation |
| title_fullStr | Acute Kidney Injury Survivor Remote Patient Monitoring: A Single Center’s Experience and an Effectiveness Evaluation |
| title_full_unstemmed | Acute Kidney Injury Survivor Remote Patient Monitoring: A Single Center’s Experience and an Effectiveness Evaluation |
| title_short | Acute Kidney Injury Survivor Remote Patient Monitoring: A Single Center’s Experience and an Effectiveness Evaluation |
| title_sort | acute kidney injury survivor remote patient monitoring a single center s experience and an effectiveness evaluation |
| topic | Telehealth digital health remote patient monitoring acute kidney injury health technology |
| url | http://www.sciencedirect.com/science/article/pii/S259005952400116X |
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