Chronic kidney disease and support provided by home care services: a systematic review

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dc.contributor.authorAydede, Sema K
dc.contributor.authorKomenda, Paul
dc.contributor.authorDjurdjev, Ognjenka
dc.contributor.authorLevin, Adeera
dc.date.accessioned2014-08-09T19:15:12Z
dc.date.available2014-08-09T19:15:12Z
dc.date.issued2014-07-18
dc.date.updated2014-08-09T19:15:33Z
dc.description.abstractAbstract Background Chronic diseases, such as chronic kidney disease (CKD), are growing in incidence and prevalence, in part due to an aging population. Support provided through home care services may be useful in attaining a more efficient and higher quality care for CKD patients. Methods A systematic review was performed to identify studies examining home care interventions among adult CKD patients incorporating all outcomes. Studies examining home care services as an alternative to acute, post-acute or hospice care and those for long-term maintenance in patients’ homes were included. Studies with only a home training intervention and those without an applied research component were excluded. Results Seventeen studies (10 cohort, 4 non-comparative, 2 cross-sectional, 1 randomized) examined the support provided by home care services in 15,058 CKD patients. Fourteen studies included peritoneal dialysis (PD), two incorporated hemodialysis (HD) and one included both PD and HD patients in their treatment groups. Sixteen studies focused on the dialysis phase of care in their study samples and one study included information from both the dialysis and pre-dialysis phases of care. Study settings included nine single hospital/dialysis centers and three regional/metropolitan areas and five were at the national level. Studies primarily focused on nurse assisted home care patients and mostly examined PD related clinical outcomes. In PD studies with comparators, peritonitis risks and technique survival rates were similar across home care assisted patients and comparators. The risk of mortality, however, was higher for home care assisted PD patients. While most studies adjusted for age and comorbidities, information about multidimensional prognostic indices that take into account physical, psychological, cognitive, functional and social factors among CKD patients was not easily available. Conclusions Most studies focused on nurse assisted home care patients on dialysis. The majority were single site studies incorporating small patient populations. There are gaps in the literature regarding the utility of providing home care to CKD patients and the impact this has on healthcare resources.
dc.description.versionPeer Reviewed
dc.identifier.citationBMC Nephrology. 2014 Jul 18;15(1):118
dc.identifier.doihttp://dx.doi.org/10.1186/1471-2369-15-118
dc.identifier.urihttp://hdl.handle.net/1993/23745
dc.language.rfc3066en
dc.rightsopen accessen_US
dc.rights.holderSema K Aydede et al.; licensee BioMed Central Ltd.
dc.titleChronic kidney disease and support provided by home care services: a systematic review
dc.typeJournal Article
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