Page 115 - Exploring the Potential of Self-Monitoring Kidney Function After Transplantation - Céline van Lint
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 Self-monitoring of renal function: a randomised trial 113
3.2. Significant reduction in number of outpatient visits
Mean number of ftf consults, telephonic consults and total number of minutes spent of both the intervention and control group are shown in figure 5. Self-monitoring led to a significant decrease in number of outpatient visits for the intention-to-treat population, with 16.02 (SD 4.93) and 18.35 (SD 3.91) ftf visits for the intervention and control group, respectively (p .007, 95% CI [-4.023 – -.651]), see table 2. Total number of reimbursable minutes spent per patient (including ftf, telephonic consults and laboratory analysis) was significantly lower for self-monitoring patients, with 286.13 (SD 90.96) minutes for the intervention versus 319.61 (67.91) minutes for the control group (p .032, 95% CI [- 63.967 – -2.991]). Sensitivity analyses with patients treated per protocol only and controlling for diabetes gave no substantially different results (data not shown).
3.3. Physician’s interaction with SMSS and self-monitoring
Following our protocol (i.e. replacing half of the ftf visits by a telephonic one after the first period of eight weeks after transplantation), the expected difference in number of ftf visits between intervention and control patients should have been 6 (given that a patients’ clinical condition allowed for visits to be replaced). As the actual difference between intervention and control group was 2.3 visits, we further investigated doctors’ involvement with the study protocol. Per doctor (N=15), total number of ftf appointments and telephonic consults for patients in the intervention group was calculated and compared to total number of logons to the SMSS. For this purpose, only patients that performed and registered measurements during the full study period were considered (N=36). For 10 doctors (67%), the number of logons to the SMSS equalled at least the number of telephonic consults with self-monitoring patients. Comparing number of logons to total number of consults (either ftf or telephonic), 10 doctors (67%) had checked the values in the SMSS in less than half of their appointments. Three of them had never logged on to the SMSS although having had multiple (telephonic) consults.
3.4. Level of self-efficacy regarding self-management behaviour similar in both study groups Self-reported self-management behaviour increased significantly over time for both the intervention and control group (p .030, 95% CI [.419 – 8.239]) No difference between intervention and control group over time was observed (see figure 4 and table 2).
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