Birgith Engelst Grove, RN MHSc PhD
Gødstrup Hospital & Aarhus University
Chronic kidney disease (CKD) is becoming more common, and improving follow-up care is key to helping patients live better lives while making the best use of healthcare resources. Remote healthcare, supported by patient-reported outcomes (PROs), offers the potential to improve follow-up care by making it more personalized and efficient compared to traditional in-person clinic visits.
Our research team aimed to explore whether remote healthcare could provide better, more tailored care, improving patients’ overall quality of life. However, the impact of transitioning from in-person to remote follow-up on kidney function, healthcare utilization, and quality of life remains unclear. This study set out to determine if remote follow-up could maintain or even improve the quality of care, reduce clinic visits, and boost patient involvement, while still protecting kidney function and efficient healthcare use.
By using PROs, we hoped to personalize care based on patients’ unique needs, leading to better health outcomes and more efficient healthcare. We conducted a randomized trial to evaluate the effectiveness of a remote approach and to determine if it could be a safe alternative to traditional in-person follow-up. In total, 152 patients with CKD were randomized into one of these groups: 1. remote PRO follow-up with patient feedback, 2. remote PRO-follow-up by telephone, and 3. regular in-hospital visits. The patients completed disease-specific PRO questionnaires from home, which were used to decide if a clinical contact was necessary. If a contact was needed, the PRO measures guided the conversation with the physician, focusing on the issues most important to the patient. We measured changes in kidney function, quality of life and healthcare usage.
Our findings showed no significant difference in kidney function between patients who had remote follow-up and those who attended regular hospital visits. However, we reduced hospital visits by 85-90% without affecting patients’ quality of life, illness perception, or satisfaction with care. The patients appreciated the convenience of avoiding travel, feeling more in control of their care, and involving their family in managing their condition. In conclusion, the study found that remote follow-up using PROs did not negatively impact kidney function nor the patients´ quality of life. Transitioning to remote care could reduce the need for clinic visits, but careful monitoring of illness progression remains important.
This research supports the integration of remote follow-up and PROs in CKD management and could be the first step toward reorganizing hospital based outpatient follow-up in renal care.
This study aligns with the growing trend of telehealth and remote patient monitoring, and it aims to make healthcare more accessible and efficient. This is particularly important in managing chronic conditions like CKD, where frequent clinic visits can be burdensome for both patients and healthcare systems. Using patient-reported outcomes may facilitate a deeper patient involvement in decisions around healthcare. The potential of using PROs in remote care is that it enables direct access to medical specialists and allows for real-time remote monitoring of patients. Remote use of PROs may help in early detection of potential health issues, enabling prompt interventions and better follow-up care. However, both healthcare providers and patients should receive thorough training on using remote follow-up technologies. This ensures everyone is comfortable and confident with the tools, leading to better engagement and outcomes. Having shown that remote follow-up for patients with CKD is safe, we are now conducting a cost-effectiveness analysis to assess potential savings for healthcare systems and the economic impact on patients.
This newsletter editorial represents the views of the author and does not necessarily reflect the views of ISOQOL.
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