TELEMEDICINE FOR OUTPATIENT CARE OF KIDNEY TRANSPLANT AND CHRONIC KIDNEY DISEASE PATIENTS

S LAMBOOY1, R KRISHNASAMY1,2, N GRAY1,3,4

1Sunshine Coast University Hospital, Birtinya, Australia, 2The University of Queensland, Herston, Australia, 3University of Sunshine Coast, Sippy Downs, Australia, 4Sunshine Coast Health Institute, Birtinya, Australia

Aim: To examine the feasibility, sustainability, and clinical outcomes of telehealth videoconferencing (TVC) for care of kidney transplant recipients (KTRs) and chronic kidney disease (CKD) patients.
Background: TVC may improve access for people in rural areas but reported uptake and clinical outcomes among KTRs especially, and CKD populations is limited.
Methods: Sixty-four participants were recruited in this single-centre, prospective, 2-year longitudinal, case-control study. Inclusion criteria for the telemedicine group included travel of ≥15km to hospital or nursing home residence, and the control group was matched for transplant or CKD status, age, and sex. The primary outcome was feasibility, defined as ≥50% of consultations in the telemedicine group being conducted by TVC in year 1. Secondary outcomes were sustainability of telemedicine (≥50% of consultations by TVC in year 2), change in blood pressure and creatinine over time, patient satisfaction (likert scale), and travel distance.
Results: There were 32 participants in both the telemedicine and control arms with no baseline differences between groups. Most were male (65.6%) with a mean age of 63.9 (12.3) years. Primary outcome was achieved with TVC uptake of 71% (IQR 50.0, 100.0) in year 1. TVC remained sustainable in year 2, although reduced significantly (50% (IQR 33.3, 71.4), p=0.004). No significant differences in change in creatinine or blood pressure occurred between groups, including KTRs and CKD sub-group analysis. Patient satisfaction was high for both groups at all timepoints. Travel distance in the TVC group decreased by 48% (16,644km) in year 1 and 37.0% (8,177km) in year 2 compared with theoretical distance.
Conclusion: TVC was feasible, sustainable, with comparable outcomes. Larger studies, especially among KTRs, are needed to confirm these findings.


Biography:
Sebastiaan Lambooy is a Medical Resident (PGY2) at the Sunshine Coast Hospital and Health Service, Queensland, Australia. Sebastiaan graduated Medicine from the University of Groningen, The Netherlands. During his medical studies, Sebastiaan commenced a PhD (MD/PhD programme) in metabolic syndrome (with emphasis on kidney and liver disease) which has resulted in a number of publications. Currently, Sebastiaan is focusing on patient-based research in Australia.

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