@文章{信息:doi/10.2196/17194，作者=“Kaiser, Paulina和Pipitone, Olivia和Franklin, Anthony和Jackson, Dixie R和Moore, Elizabeth A和Dubuque, Christopher R和Peralta, Carmen A和De Mory, Anthony C”，标题=“晚期慢性肾脏疾病管理的虚拟多学科护理计划:匹配队列研究”，期刊=“J Med Internet Res”，年=“2020”，月=“Feb”，日=“12”，卷=“22”，数=“2”，页=“e17194”，关键词=“慢性肾脏疾病;终末期肾病;在线社交网络;病人教育;背景:对于晚期慢性肾脏疾病(CKD)患者的虚拟多学科护理计划是否能提高他们对疾病的认识，增加他们对家庭透析治疗的兴趣，并导致更多计划的门诊(相对于住院)透析开始，目前还没有很好的确定。目的:我们旨在评估社区肾病实践中晚期CKD患者参与项目与疾病知识、家庭透析方式偏好和门诊透析起始的可行性和初步关联。方法:在一个匹配的前瞻性队列中，我们招募了年龄在18至85岁之间，至少有两种肾小球滤过率(eGFR)估计小于30 mL/min/1.73 m2的成年人进入蟋蟀健康计划，并将他们与在同一诊所接受治疗的对照组进行比较，年龄、性别、eGFR、心力衰竭和糖尿病的存在相匹配。干预包括在线教育材料、虚拟多学科团队(护士、药剂师、社会工作者、营养师)和患者导师。预先指定的随访时间为9个月，并延长随访时间，以便有足够的时间确定透析开始时间。CKD知识和透析方式的选择在干预参与者的前后调查中进行评估。 Results: Thirty-seven participants were matched to 61 controls by age (mean 67.2, SD 10.4 versus mean 68.8, SD 9.5), prevalence of diabetes (54{\%}, 20/37 versus 57{\%}, 35/61), congestive heart failure (22{\%}, 8/37 versus 25{\%}, 15/61), and baseline eGFR (mean 19, SD 6 versus mean 21, SD 5 mL/min/1.73 m2), respectively. At nine-month follow-up, five patients in each group started dialysis (P=.62). Among program participants, 80{\%} (4/5) started dialysis as an outpatient compared with 20{\%} (1/5) of controls (OR 6.28, 95{\%} CI 0.69-57.22). In extended follow-up (median 15.7, range 11.7 to 18.1 months), 19 of 98 patients started dialysis; 80{\%} (8/10) of the intervention group patients started dialysis in the outpatient setting versus 22{\%} (2/9) of control patients (hazard ratio 6.89, 95{\%} CI 1.46-32.66). Compared to before participation, patients who completed the program had higher disease knowledge levels (mean 52{\%}, SD 29{\%} versus mean 94{\%}, SD 14{\%} of questions correct on knowledge-based survey, P<.001) and were more likely to choose a home modality as their first dialysis choice (36{\%}, 7/22 versus 68{\%}, 15/22, P=.047) after program completion. Conclusions: The Cricket Health program can improve patient knowledge about CKD and increase interest in home dialysis modalities, and may increase the proportion of dialysis starts in the outpatient setting. ", issn="1438-8871", doi="10.2196/17194", url="//www.mybigtv.com/2020/2/e17194/", url="https://doi.org/10.2196/17194", url="http://www.ncbi.nlm.nih.gov/pubmed/32049061" }