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Chronic Kidney DiseasesTelemechronNCT05906927

Telemedicine for Home-based Management of Patients With Chronic Kidney Diseases and Comorbidities (NET-2018-12367206)

An observational study of Chronic Kidney Diseases, run by Azienda USL Toscana Nord Ovest at 1 site in Italy.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This project is aimed to analyze the current models and to design innovative strategies to improve quality of care and optimise resource utilization of telemedicine (TM) in home-based management for the global care of patients with chronic kidney diseases (CKD). Read more about this study

Who is it for?
Any age
Conditions the study is for
Chronic Kidney Diseases
How many people
8 participants
Where
1 siteItaly
Study dates
1 Aug 2022to 30 Sep 2024
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Study population: We propose to consider 3 case studies: 2 patients on peritoneal dialysis , 2 patients on home hemodialysis and 4 patients attending pre-dialysis clinic .

Who may be able to join

  • patients already on treatment both in continuous home peritoneal dialysis (CAPD) and patients in nocturnal automated peritoneal dialysis (IPD)
  • autonomous in their management of dialysis therapy,
  • absence of acute or rapidly disabling comorbidities,
  • ability to use a smart phone,
  • home covered by fast optical fiber
  • Patients already in treatment, autonomous in their management of home dialysis therapy, or in dialysis at peripheral centers where the continuous presence of the nephrologist is not guaranteed
Show all 15Show fewer
  • Absence of acute or rapidly disabling comorbidities,
  • Presence of a stable and well-functioning vascular access for hemodialysis,
  • Ability to use a smart phone,
  • Home covered by fast optical fiber
  • Inclusion Criteria for Chronic nephropathic patients undergoing predialysis:
  • Patients already taken care of by the facility,
  • Absence of acute or rapidly disabling comorbidities,
  • Ability to use a smart phone,
  • Home covered by fast optical fiber

Who cannot join

  • History of malignant hypertension or accelerated hypertension within 6 months prior to study entry.
  • History of drugs i.v. or alcohol abuse. History of cocaine abuse will be an exclusion criterion.
  • Serious systemic disease that could affect the survival or course of the kidney disease.
  • Body mass index greater than 35 Kg/m2 in men and 33 Kg/m2 in women. BMI is calculated as weight (kg)/height (m2).
  • Myocardial infarction or cerebrovascular accident in the past 6 months
  • Pregnancy or likelihood of becoming pregnant during the study period.
  • Using nonsteroidal anti-inflammatory drugs (NSAIDs) for more than 1 week/month, excluding baby aspirin.
  • Suspect that the participant will not be able to meet the protocol visits schedule.

Trial locations and contacts

1 site in 1 country.

Italy1 site
  • Azienda Sanitaria NordOvest Toscana

    Livorno, Tuscany, 57100

Other trials in Italy

About this study

Official title: Telemedicine for Home-based Management of Patients With Chronic Kidney Diseases and Comorbidities: Analysis of Current Models and Design of Innovative Strategies to Improve Quality of Care and Optimise Resource Utilization

This project is aimed to analyze the current models and to design innovative strategies to improve quality of care and optimise resource utilization of telemedicine (TM) in home-based management for the global care of patients with chronic kidney diseases (CKD). The main focus is on the prevention of complications, recurrence of unstabilization and optimal therapy for the global management of chronic pts through TM and e-Health. Reducing avoidable/unnecessary hospitalisation of pts with chronic conditions, through the effective implementation of a health care network, offering integrated care programs and applying chronic disease management models, should ultimately contribute to the improved efficiency of health systems.

Read the detailed description

The investigators will design, test and evaluate innovative models for applying TM to the management of pts with chronic kidney diseases .

New models will be characterized by the followings:

  • flexible adaptation to pts subgroups/ individual pts characteristics, including pts (and caregivers) expectation and willingness to participate actively in the process of care
  • identification of technical components which are essential, accessory, useful or futile for different pts subgroups, including evaluation of pts abilities and preferences.
  • definition of the team of care and the roles and responsibilities of each components: case manager, clinical manager etc
  • pre-definition of outcome measures, that should include at least the evaluation of quality of life, perceived quality of care by the pts and caregivers, number and duration of hospitalizations.
  • definition of Quality Assurance (QA) derived indicators related to risk and performance of TM implementation where needed

Finally, the investigators will collect a set of data allowing to analyse and validate the care model and to measure the patient adherence to the care plan as well as measure the performance of the predictive models based on this data.

Medical subject headings
Renal Insufficiency, Chronic

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from baseline number of days of hospitalization at 6 and 12 months

    A comparison among the baseline number of days of hospitalization and the ones at 6 and 12 months will be performed. Data will be extracted from the data flows of healthcare information systems

    Measured: Baseline, 6 months and 12 months

  2. Change from baseline number of home visits by the doctor at 6 and 12 months

    A comparison among the baseline number of home visits by the doctor and the ones at 6 and 12 months will be performed. Data will be extracted from the data flows of healthcare information systems

    Measured: Baseline, 6 months and 12 months

  3. Change from baseline number of doctor's office visits at 6 and 12 months

    A comparison among the baseline number of doctor's office visits and the ones at 6 and 12 months will be performed. Data will be extracted from the data flows of healthcare information systems

    Measured: Baseline, 6 months and 12 months

  4. Change from Baseline number of nephrologist's office visits at 6 and 12 months

    A comparison among the baseline number of nephrologist's office visits and the ones at 6 and 12 months will be performed. Data will be extracted from the data flows of healthcare information systems

    Measured: Baseline, 6 months and 12 months

  5. Change from baseline Dialyzer clearance of urea multiplied by dialysis time and normalized for urea distribution volume (Kt/V) at 6 and 12 months

    A comparison among the baseline Kt/V and the one at 6 and 12 months will be performed. Data will be extracted from the Tests Laboratory data flows

    Measured: Baseline, 6 months and 12 months

  6. Change from baseline Estimated Glomerular Filtration Rate (eGFR) at 6 and 12 months

    A comparison among the baseline eGFR and the one at 6 and 12 months will be performed. Data will be extracted from the Tests Laboratory data flows

    Measured: Baseline, 6 months and 12 months

  7. Change from baseline Hb at 6 and 12 months

    A comparison among the baseline Hb and the one at 6 and 12 months will be performed. Data will be extracted from the Tests Laboratory data flows

    Measured: Baseline, 6 months and 12 months

  8. Change from baseline Ca/P at 6 and 12 months

    A comparison among the baseline Ca/P and the one at 6 and 12 months will be performed. Data will be extracted from the Tests Laboratory data flows

    Measured: Baseline, 6 months and 12 months

  9. Change from baseline Parathyroid hormone (PTH) levels at 6 and 12 months

    A comparison among the baseline PTH and the one at 6 and 12 months will be performed. Data will be extracted from the Tests Laboratory data flows

    Measured: Baseline, 6 months and 12 months

  10. Change from baseline Average weight loss in HD/PD at 6 and 12 months

    A comparison among the baseline Average weight loss in HD/PD and the one at 6 and 12 months will be performed. Data will be extracted from the patients' clinical health record

    Measured: Baseline, 6 months and 12 months

  11. Change from baseline Weight at 6 and 12 months

    A comparison among the baseline Weight and the one at 6 and 12 months will be performed. Data will be extracted from the patients' clinical health record

    Measured: Baseline, 6 months and 12 months

  12. Change from baseline HD complications at 6 and 12 months

    A comparison among the baseline Intratreatment and Extra treatment HD complications and the ones at 6 and 12 months will be performed. Data will be extracted from the patients' clinical health record

    Measured: Baseline, 6 months and 12 months

  13. Change from baseline PD complications at 6 and 12 months

    A comparison among the baseline Intratreatment and Extra treatment HD complications and the ones at 6 and 12 months will be performed. Data will be extracted from the patients' clinical health record

    Measured: Baseline, 6 months and 12 months

  14. Change from baseline Total number of prescribed drugs at 6 and 12 months

    A comparison among the baseline Total number of prescribed drugs and the one at 6 and 12 months will be performed. Data will be extracted from the patients' clinical health record

    Measured: Baseline, 6 months and 12 months

  15. Change from 6 months Satisfaction score of the system at 12 months (5-level scale)

    A comparison between the overall satisfaction rating of the system at 6 and 12 months will be carried out.

    A 5-level scale is used (interval scale: 1 to 5): 1=Very Unsatisfied, 2= Unsatisfied, 3=Neutral, 4=Satisfied, 5=Very Satisfied.

    Information collected through a specific questionnaire.

    Measured: 6 months and 12 months

  16. Change from 6 months Usability index of the system at 12 months

    A comparison between the Usability rating of the whole system and of the individual devices at 6 and 12 months will be carried out. Information collected through a specific questionnaire.

    Measured: 6 months and 12 months

  17. Change from 6 months Time acceptability index at 12 months

    A comparison between the Patients' acceptance of the time required for the system daily usage at 6 and 12 months will be carried out. Information collected through a specific questionnaire.

    Measured: 6 months and 12 months

  18. Change from 6 months Acceptance of a potential systematic usage at 12 months

    A comparison between the Patients' acceptance of a potential systematic usage of the system at 6 and 12 months will be carried out. Information collected through a specific questionnaire.

    Measured: 6 months and 12 months

  19. Total number of measurements (systolic blood pressure, pulse rate, oxygen saturation, temperature, weight, electrocardiogram, bio-electrical impedance analysis)

    Total number of measurements (systolic blood pressure, pulse rate, oxygen saturation, temperature, weight, electrocardiogram, bio-electrical impedance analysis) performed by patients through the devices he is equipped with.

    Data will extracted from the system service platform.

    Measured: 12 months

  20. Total number of measurements (systolic blood pressure, pulse rate, oxygen saturation, temperature, weight, electrocardiogram, bio-electrical impedance analysis) per patient

    Total number of measurements performed by each patient through the devices he is equipped with.

    The measurements include the following parameters: systolic blood pressure, pulse rate, oxygen saturation, temperature, weight, electrocardiogram, bio-electrical impedance analysis parameters.

    Data will extracted from the system service platform.

    Measured: 12 months

  21. Total number of measurements per parameter (systolic blood pressure, pulse rate, oxygen saturation, temperature, weight, electrocardiogram, bio-electrical impedance analysis)

    Total number of measurements per parameter (systolic blood pressure, pulse rate, oxygen saturation, temperature, weight, electrocardiogram, bio-electrical impedance analysis) performed by patients through the devices he is equipped with.

    Data will extracted from the system service platform.

    Measured: 12 months

  22. Total number of measurements per parameter (systolic blood pressure, pulse rate, oxygen saturation, temperature, weight, electrocardiogram, bio-electrical impedance analysis) per patient

    Total number of measurements per parameter (systolic blood pressure, pulse rate, oxygen saturation, temperature, weight, electrocardiogram, bio-electrical impedance analysis) performed by each patient through the devices he is equipped with.

    Data will extracted from the system service platform.

    Measured: 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Jun 2023
  2. Study start1 Aug 2022
  3. Primary completion30 Aug 2024 (estimated)
  4. Study completion30 Sep 2024 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Cross-sectional
Enrolment
8 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05906927
Sponsor's protocol ID
Telemechron WP1-40/2019
Acronym
Telemechron
Status last verified
Oct 2023
First submitted
2 Mar 2023
Last updated
26 Oct 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Young A, Orchanian-Cheff A, Chan CT, Wald R, Ong SW. Video-Based Telemedicine for Kidney Disease Care: A Scoping Review. Clin J Am Soc Nephrol. 2021 Dec;16(12):1813-1823. doi: 10.2215/CJN.06660521. Epub 2021 Dec 7.

    PubMed 36630403
  • Lindeboom L, Lee S, Wieringa F, Groenendaal W, Basile C, van der Sande F, Kooman J. On the potential of wearable bioimpedance for longitudinal fluid monitoring in end-stage kidney disease. Nephrol Dial Transplant. 2022 Oct 19;37(11):2048-2054. doi: 10.1093/ndt/gfab025.

    PubMed 33544863
  • Gc VS, Iglesias CP, Erdem S, Hassan L, Peek N, Manca A. Using discrete-choice experiments to elicit preferences for digital wearable health technology for self-management of chronic kidney disease. Int J Technol Assess Health Care. 2022 Oct 26;38(1):e77. doi: 10.1017/S0266462322003233.

    PubMed 36286261

Questions about this trial

What is this clinical trial studying?

An observational study of Chronic Kidney Diseases, run by Azienda USL Toscana Nord Ovest at 1 site in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 15 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 26 Oct 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from baseline number of days of hospitalization at 6 and 12 months (time frame: Baseline, 6 months and 12 months). The study lists 22 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05906927, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Oct 2023.

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