Clinical Efficacy of a Home-based Peritoneal Dialysis Management Program

초록

Introduction: Patients undergoing peritoneal dialysis (PD) require strong self-management support to reduce the risk of PD-related complications; however, the best methods are unclear. The Korean Ministry of Health and Welfare has initiated a chronic disease management pilot program. This study aimed to determine the clinical outcomes and potential effects of a home-based PD management program. Methods: We analyzed National Health Insurance Service claims data from December 2019 to October 2021. A total of 6086 patients on PD were divided into 2 groups based on whether they were enrolled in a home-based management program. Outcomes included hospitalization rates, emergency room visits, mortality, and technical survival. Cox proportional hazard models were used to analyze the risk of death and technical failure in these groups. Results: The proportion of patients enrolled in home-based management and those not enrolled were 51.4% and 48.6%, respectively. Patients in the intervention group had fewer hospitalizations and fewer hospital days per hospitalization than those in the control group. They had significantly fewer emergency room visits than those in the control group. The intervention group had a lower mortality and a reduced risk of technical failure than the control group. This finding was similar among prevalent and incident patients. Conclusion: The home-based management program for PD was clinically effective in improving hospitalization, technical survival, and mortality. This program may provide an efficient treatment option for patients on PD, and positive outcomes could lead to expanded programs that include more patients.

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