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Abstract: TH-PO256

A 6-Month Program of Intradialytic Cycling Results in a Reduction in Associated Healthcare Costs in Patients Receiving Prevalent Hemodialysis

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • March, Daniel Scott, University of Leicester, Leicester, United Kingdom
  • Hurt, Adam Willis, University of Leicester, Leicester, United Kingdom
  • Smith, Alice C., University of Leicester, Leicester, United Kingdom
  • Burton, James, University of Leicester, Leicester, United Kingdom
Background

Individuals receiving hemodialysis have complex medical needs. Interventions that reduce health care utilization can improve patient outcomes, and therefore decrease the financial burden. The aim of this health economic analysis is to investigate the effect of a 6-month program of intra-dialytic cycling exercise (IDE) on health care costs.

Methods

This is a retrospective complete case analysis of a 100 participants enrolled in CYCLE-HD, an open-label, blinded end-point, cluster randomised control trial investigating the benefit of IDE. Participants were randomised to either a 6-month progressive program of IDE (30 minutes of thrice weekly, moderate intensity cycling at RPE 12-14) or standard care (control). Data on hospital admissions, length of stay, clinic appointments, A&E attendances, primary care appointments and prescribed medications were extracted from medical records for the 6-months before, during and after the IDE intervention. Costs of healthcare utilization were calculated using the National Health Insurance National Tariff Payment System, and prescribed medications were calculated using the British National Formulary. Data are presented as mean difference (95% confidence interval) or mean (95% confidence interval).

Results

Data from a 100 participants (control n=49 and IDE n=51) were included in our complete case analysis. Time-series with incomplete data sets were excluded. There was no difference between groups for the before (£284.30 (-£4550.24 to £5118.83), P=0.9075) or during (-£2124.67 (-£6466.69 to £2217.35), P=0.3342) periods. However following the IDE program there was a significant reduction in cost of -£8199.438 (-£15137.43 to -£715.4473, P=0.0227) per participant between IDE and control groups. Similarly, post IDE number of admissions (IDE; 0.8 (0.4-1.2), control; 1.2 (0.8-1.6)) and length of stay (IDE; 3.1 (0.2-6.0) days, control; 4.4 (2.4-6.3) days) were also reduced.

Conclusion

These data show a 6-month of program IDE can reduce associated health economic costs. The overall reduction appears to be driven by a reduction in hospital admissions and length of stay. These results strengthen the argument that IDE programs should be routinely offered and are of crucial importance to commissioners of dialysis care.