Continuity of care for quality of life and clinical outcomes in patients with peritoneal dialysis

Objective: To evaluate the effect of continuity of care (COC) on the quality of life (QOL), clinical outcomes and complications in patients undergoing peritoneal dialysis (PD). Methods: A total of 118 patients were selected among the patients received continuous ambulatory PD in the Department of Nephropathy in our hospital from January 2014 December 2015. They were allocated into the continuity of care group (the intervention group) and the control group in terms of the care methods. The patients in the control group were assigned to receive routine telephone follow-ups while those in the intervention group were assigned to receive continuous ambulatory care intervention for 12 weeks. The improvements in QOL and renal functions between the two groups were compared based on the Kidney Disease Quality of Life Short Form (KDQOL-SF) scale, the creatinine clearance rate (CCR) and the urea clearance index (KT/V) of renal function at discharge, 6 and 12 weeks after discharge, respectively. Besides, the rates of peritonitis, catheter exit-site infection, electrolyte imbalance and other complications were compared between the two groups at the end of the 12-week follow-up. Results: In the KDQOL-SF scale, the scores of the three dimensions including the effects of kidney disease (P=0.019), general health perception (P=0.015), and overall health (P=0.042) were significantly improved in the two groups; the scores of symptoms (P=0.048), staff encouragement (P=0.037) and patient satisfaction (P=0.044) scores were strikingly higher in the intervention group than in the control group. There were significant interactions between the COC and time in the three dimensions of sleep, staff encouragement and patient satisfaction. The CCR rate in the intervention group was greatly higher than that of the control group (P=0.047), but the rate of peritonitis was significantly lower than that of the control group (10.3% vs 25%, P=0.037). Conclusion: COC can effectively enhance the QOL of patients with PD, reduce the incidence of peritonitis, and improve the effectiveness of PD.