Retraining programme for older patients undergoing peritoneal dialysis: A randomised controlled trial

IF 1.5 4区医学 Q3 NURSING

Journal of renal care Pub Date : 2022-12-04 DOI:10.1111/jorc.12450

Wai Yin Leung RN, FNP-BC, DNurs, Marques S. N. Ng RN, PhD, Anthony K. C. Hau MBChD, MRCP, Winnie K. W. So RN, PhD, FAAN

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引用次数: 3

Abstract

Background

Peritonitis is a common cause of hospitalisation and death among patients undergoing peritoneal dialysis. Periodic retraining is recommended to prevent peritonitis, especially in older adults.

Objectives

We evaluated the effectiveness of a retraining programme for reducing peritonitis and exit site infection rates in older adults on peritoneal dialysis. The cost–benefit ratio was also calculated.

Design

A two-arm prospective randomised controlled trial.

Participants

One hundred and thirty patients aged 55 years or older were recruited. Participants were randomly assigned to the intervention or control group. While both groups received usual care, the intervention group received a retraining programme (a knowledge and practical assessment and a one-on-one retraining session) 90 days after starting home-based continuous ambulatory peritoneal dialysis therapy.

Measurements

The outcomes included peritonitis rate, exit site infection rate and direct medical costs at 180, 270, and 360 days after starting home-based continuous ambulatory peritoneal dialysis therapy.

Results

No significant differences were found in the baseline characteristics between groups. The peritonitis rates were 0.11 episodes per patient-year in the intervention group versus 0.13 in the control group. The incidence of exit site infection was 20.0% in the intervention group and 12.3% in the control group. The cost–benefit ratio of retraining was 1:9.6. None of the results were statistically significant.

Conclusions

The absence of statistical significance may be partly explained by the premature termination of the study. Large-scale multi-centre trials are warranted to examine the effectiveness of retraining. The timing and long-term effects of retraining also need to be examined.

查看原文本刊更多论文

老年腹膜透析患者的再培训方案:一项随机对照试验。

背景:腹膜炎是腹膜透析患者住院和死亡的常见原因。建议定期再训练以预防腹膜炎，尤其是老年人。目的:我们评估再培训计划在减少腹膜透析老年人腹膜炎和出口部位感染率方面的有效性。并计算了成本效益比。设计:两组前瞻性随机对照试验。参与者:招募了130名年龄在55岁或以上的患者。参与者被随机分配到干预组和对照组。两组均接受常规护理，干预组在开始以家庭为基础的连续流动腹膜透析治疗90天后接受再培训计划(知识和实践评估以及一对一的再培训课程)。测量:结果包括在开始以家庭为基础的连续动态腹膜透析治疗后180、270和360天的腹膜炎发生率、出口部位感染率和直接医疗费用。结果:两组间基线特征无显著差异。干预组的腹膜炎发生率为0.11次/患者年，对照组为0.13次/患者年。干预组出口部位感染发生率为20.0%，对照组为12.3%。再培训的成本效益比为1:6 6。这些结果都没有统计学意义。结论:缺乏统计学意义可能部分解释为过早终止研究。有必要进行大规模的多中心试验来检验再培训的有效性。再培训的时机和长期影响也需要加以审查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of renal care Nursing-Advanced and Specialized Nursing

CiteScore

3.50

自引率

5.30%

发文量

期刊介绍： The Journal of Renal Care (JORC), formally EDTNA/ERCA Journal, is the official publication of the European Dialysis and Transplant Nursing Association/European Renal Care Association (EDTNA/ERCA). The Journal of Renal Care is an international peer-reviewed journal for the multi-professional health care team caring for people with kidney disease and those who research this specialised area of health care. Kidney disease is a chronic illness with four basic treatments: haemodialysis, peritoneal dialysis conservative management and transplantation, which includes emptive transplantation, living donor & cadavaric transplantation. The continuous world-wide increase of people with chronic kidney disease (CKD) means that research and shared knowledge into the causes and treatment is vital to delay the progression of CKD and to improve treatments and the care given. The Journal of Renal Care is an important journal for all health-care professionals working in this and associated conditions, such as diabetes and cardio-vascular disease amongst others. It covers the trajectory of the disease from the first diagnosis to palliative care and includes acute renal injury. The Journal of Renal Care accepts that kidney disease affects not only the patients but also their families and significant others and provides a forum for both the psycho-social and physiological aspects of the disease.