Original InvestigationPathogenesis and Treatment of Kidney Disease and HypertensionPredialysis Psychoeducational Intervention Extends Survival in CKD: A 20-Year Follow-Up
Section snippets
Participants
The method relating to the first predialysis psychoeducational intervention cohort has been described previously.20 Briefly, between August 1983 and January 1988, we attempted to identify all individuals at our participating hospitals in Montreal (Royal Victoria Hospital, Montreal General Hospital, Centre Hospitalier Cotes-des-Neiges, and St. Mary’s Hospital) and Calgary, Canada (Foothills Hospital and its satellite centers in Lethbridge, Medicine Hat, and Vulcan, Alberta) with deteriorating
Description of Cohort
We identified 588 prospective participants. This included 400 people (68%) who agreed to enter the cohort and 188 people (32%) who did not enter for a variety of reasons (most commonly because they were very seriously ill, moribund, or died shortly after being identified). Of those who entered the study, 32 patients (8.0% of the enrolled cohort) did not progress beyond the first data-collection point (eg, because of death, transfer, or loss to follow-up). Of the remainder, 172 patients (46.5%)
Discussion
Predialysis psychoeducational interventions increase relevant knowledge and extend time to dialysis therapy. In the present study, we observed a statistically significant survival advantage for predialysis psychoeducational intervention recipients after adjusting for age, general nonrenal health at inception, and time between identification and receipt of predialysis psychoeducational intervention or usual care. Predialysis psychoeducational intervention recipients survived a median of 2.25
Acknowledgment
The authors thank the collaborators, clinical staff, and patients at all participating hospitals, especially the project coordinators Linda Barron and Marjorie MacDonald (Calgary) and Ruth Nabi and Nettie Harris (Montreal); Janet Hargrove for meticulous data management and processing; all other research personnel involved in this work; and the University Health Network (Toronto) Quality of Life Manuscript Review Seminar for valuable feedback on earlier versions of this article.
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Originally published online as doi:10.1053/j.ajkd.2005.08.017 on October 13, 2005.
Supported in part by research grant no. 6606-5345-403 from the National Health Research and Development Program (G.M.D., Y.M.B.; co-principal investigators); Ortho-Biotech Inc (Y.M.B., G.M.D.); and Canadian Institutes of Health Research (Senior Investigator Award, G.M.D.).