Abstract: TH-PO270
Functional Status Index Directed Care in the Patient-Centered Supportive Care Pilot
Session Information
- Hemodialysis and Frequent Dialysis - II
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Han, Hao, Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Chaudhuri, Sheetal, Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Demaline, Jessica, Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Casamento, Cheryl E., Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Butler, Karen G., Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Reviriego-Mendoza, Marta, Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Larkin, John W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Maddux, Dugan, Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Usvyat, Len A., Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Maddux, Franklin W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
Background
A large dialysis organization (LDO) developed a functional status index (FSI) that can identify hemodialysis (HD) patients who are experiencing a lower level of functional status. The LDO performed Patient Centered Supportive Care (PCSC) pilot that identified HD patients with a decreasing/diminished FSI and provided targeted interventions based on identified barriers. We assessed if the FSI-directed intervention was associated with improvements in the FSI score.
Methods
We used data from 8 PCSC pilot clinics between 04/13/2018 to 10/30/2018. The FSI uses an array of clinical data and is computed via Z scores and weighted assignments of parameters. In the PCSC pilot, FSI-directed intervention was provided over 28 weeks to patients with a low and decreasing trend in their FSI score. This intervention included targeted clinical recommendations related to treatment adherence, weight management, nutrition, financial assistance, medications and comorbidities, as well as, external referrals to specialists. We calculated the percent of patients who had an increase in their FSI score from baseline in the FSI-directed intervention (FSI positive) versus standard of care (SOC) group who did not have an intervention (FSI negative).
Results
We analyzed data from 497 HD patients at the 8 PCSC pilot clinics. FSI-directed intervention was provided to 42 patients. Patients with a low/decreasing FSI score had a higher mortality rate (14% FSI positive and 6% FSI negative SOC). Over the course of the pilot, 58% of the survivors with FSI-directed intervention had an increase in their FSI score compared to baseline. In the SOC group, 47% of survivors without the intervention had an increase in their FSI score.
Conclusion
The FSI-directed intervention was associated with >10% higher proportion of patients having an improvement in their FSI score. As anticipated, the FSI score identifies patients with higher mortality rates. Additional testing of the FSI-directed intervention is needed to confirm these observations.
Funding
- Commercial Support –