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Early rehospitalization after initial chronic kidney disease educational hospitalization relates with a
Eiji Kose1, Taesong An2, Akihiko Kikkawa2
1Department of Pharmacotherapy, School of Pharmacy, Nihon University, 7-7-1 Narashinodai, Funabashi-shi, Chiba 274-8555 Japan.
Insights
Insufficient instruction from healthcare professionals contributes to early rehospitalization in chronic kidney disease (CKD) patients. A multidisciplinary medical team approach is crucial for improving patient outcomes and reducing readmissions after educational hospitalization.
Area of Science:
- Nephrology
- Public Health
- Patient Education
Background:
- Chronic kidney disease (CKD) is linked to end-stage renal failure and cardiovascular disease.
- Educational hospitalization is vital for early CKD management in Japan, yet post-discharge compliance issues lead to rehospitalization.
- This study investigates factors contributing to early rehospitalization after CKD educational hospitalization.
Purpose of the Study:
- To identify factors associated with early rehospitalization in patients with chronic kidney disease (CKD) following educational hospitalization.
- To compare characteristics of patients who were rehospitalized early versus those who were not.
Main Methods:
- A cohort of 137 patients discharged from CKD educational hospitalization in Japan (March 2011-December 2012) was analyzed.
- Patients were divided into early rehospitalization and control groups.
- Multiple logistic regression and Kaplan-Meier analyses were performed, adjusting for confounding variables.
Main Results:
- Insufficient instruction from physicians, pharmacists, and dietitians emerged as an independent explanatory variable for early rehospitalization.
- Patients receiving adequate instruction demonstrated a significantly higher probability of remaining non-rehospitalized.
- A multidisciplinary medical team approach is essential for addressing early rehospitalization in CKD patients.
Conclusions:
- Care provided by a multidisciplinary medical team is critical for managing patients with chronic kidney disease (CKD).
- Implementing comprehensive care from physicians, pharmacists, and dietitians can effectively reduce early rehospitalization rates in CKD patients.
Background:
It is well-documented that chronic kidney disease (CKD) often results in end-stage renal failure and puts patients at extremely high risk for developing cardiovascular disease. Educational hospitalization at medical institutions in Japan is important for patients with CKD because it facilitates treatment in earlier stages of CKD when subjective symptoms are not apparent. However, some patients who have achieved their educational targets tend to have poor compliance at home after discharge from the hospital, resulting in rehospitalization shortly. In this study, we examined the factors for early rehospitalization of patients after initial CKD educational hospitalization compared with non-rehospitalized patients.
Methods:
One hundred thirty-seven patients after discharge from CKD educational hospitalization in Japan between March 2011 and December 2012 were included in the analyses. The subjects were classified into two groups: the early rehospitalization group and control group. We adjusted for confounding variables and performed multiple logistic regression analysis with the presence or absence of early rehospitalization as a dependent variable to investigate the association of early rehospitalization with patient background features, laboratory data, vital signs, instruction-related items, and home environment.
Results:
Study subjects included 22 patients in the early hospitalization group and 115 patients in control group. Multivariable analysis for early rehospitalization indicated that insufficient instruction by physician, pharmacist, and dietitians was independent explanatory variable. Analyzing by Kaplan-Meier method, the probability of non-rehospitalization in the instruction group was significantly higher than that in the non-instruction group. Therefore, we believe it is necessary to involve a competent, multidisciplinary medical team (consisting of physicians, pharmacists, and dietitians) in addressing the early rehospitalization issue in patients with CKD.
Conclusion:
These findings confirm the importance of care by a multidisciplinary medical team in patients with CKD. Therefore, we suggest that care by a multidisciplinary medical team reduces the increase of early rehospitalization in patients with CKD.
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