Early Intervention Helps Those With End-Stage Renal Disease, Says Report

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Early Intervention Helps Those With End-Stage Renal Disease, Says Report
RightStart Program Provides Immediate Medical Intervention and Increased Patient Education

By Patty Oh
Published Oct 18, 2007

In a recent press release, researchers announced that early education, self-empowerment and close medical attention reduced the hospitalization rate and mortality for people suffering from end-stage renal disease (ESRD). Researchers developed a program, named RightStart, to help educate and provide close medical care for ESRD patients.

Researchers report that when patients are first diagnosed with ESRD, they are often malnourished. They need to have intense and focused care from the beginning of dialysis to have the best outcome.

They undertook starting the RightStart program, targeted to reach patients right after they start dialysis. Their goal was to help these patients learn more about what they could do to help themselves, and provide the needed medical intervention from the very beginning.

In addition to helping make appropriate medical interventions, another of the key points was to provide nutritional education. The nutritional education for ESRD patients emphasized why the body needed calories and protein and how insufficient calories and protein would be harmful to ones body.

Case managers were assigned to each patient. The case manager was responsible for addressing medical problems that a patient might have within their first few weeks of dialysis. Case managers worked on a proactive basis, instead of being reactionary.

Researchers determined that after completing three months on the ESRD RightStart programs, patients' lives were improved dramatically. Blood tests showed that they were not anemic, and they had sufficient levels of nutrients in their blood so they were not malnourished. The patients also knew much more about ESRD and steps that they could take to improve their own lives.

"This program for new patients has shown itself to dramatically improve outcomes, when compared to a control group that did not receive the intervention," comments Dr. Raymond Hakim of Fresenius Medical Care in Brentwood, Tenn.

Researchers discovered patients who participated in that the ESRD RighStart program, after starting dialysis, spent fewer days in the hospital. RightStart patients were hospitalized for fewer days (an average of 7.2 days) compared with those who were not part of the RightStart program (an average of 10.5 days).

Further, the mortality rate for ESRD RightStart patients was reduced significantly. RightStart mortality was 17 deaths per 100 patient-years, compared to 30 deaths per 100 patient-years for those who did not participate in the ESRD RightStart dialysis program. Death rates were reduced by 40 percent for patients a year after they began dialysis.

"The lack of payment coverage by Medicare for patients less than 65 years old is a major impediment to providing such patients with timely education and preventive measures," said Dr. Raymond Hakim.

Source:
http://www.eurekalert.org/pub_releases/2007-10/ason-eid101807.php