Abstract
Background. There are wide national and international variations in the management of patients with endstage renal disease (ESRD). The aim of this study was to develop, harmonize, implement, and evaluate consensus-based clinical guidelines for the management of renal anaemia and renal bone disease in patients with ESRD, and for the prevention and management of cytomegalovirus disease in renal transplant recipients across six renal centres in Europe.
Methods. The trial was a prospective, multicentre, randomized balanced incomplete block design. Nephrologists from the six European renal units were randomized to develop and implement guidelines for two out of the three conditions and to act as a control for the third condition. Data were collected pre- (1 year) and post- (9 months) intervention on aspects of patient monitoring, management, and outcome.
Results. Eight hundred and twenty-nine dialysis patients from the six European dialysis centres were included in the study. Multivariate analysis (adjusting for case-mix and secular trends) showed a significant increase in the number of monitoring events in the guideline group compared with control group (6%, 95% CI, 1-11%). There was no concomitant increase in either appropriate management or the number of favourable patient outcomes.
Conclusions. In the first European collaboration on renal guidelines, the introduction of the guidelines improved the monitoring of the patients, but did not improve patient management or outcome. This study suggests the potential for creating clinical guidelines with the aim of standardizing treatment protocols across international boundaries, and improving the quality of the medical care provided.
| Original language | English |
|---|---|
| Pages (from-to) | 1394-1398 |
| Number of pages | 5 |
| Journal | Nephrology Dialysis Transplantation |
| Volume | 15 |
| Publication status | Published - 2000 |
Keywords
- CAPD
- clinical guidelines
- cluster randomized trial
- European guidelines
- haemodialysis
- REPLACEMENT THERAPY
- OUTCOMES
Cite this
Evaluation of clinical guidelines for the management of end-stage renal disease in Europe: the EU BIOMED 1 Study. / Ramsay, C R ; Campbell, M K ; Cantarovich, D ; Catto, G ; Cody, J ; Daly, C ; Delcroix, C ; Edward, N ; Grimshaw, J M ; van Hamersvelt, H W ; Henderson, I S ; Khan, I H ; Koene, R A P ; Papadimitrou, M ; Ritz, E ; Tsakiris, D ; MacLeod, A M .
In: Nephrology Dialysis Transplantation, Vol. 15, 2000, p. 1394-1398.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Evaluation of clinical guidelines for the management of end-stage renal disease in Europe: the EU BIOMED 1 Study
AU - Ramsay, C R
AU - Campbell, M K
AU - Cantarovich, D
AU - Catto, G
AU - Cody, J
AU - Daly, C
AU - Delcroix, C
AU - Edward, N
AU - Grimshaw, J M
AU - van Hamersvelt, H W
AU - Henderson, I S
AU - Khan, I H
AU - Koene, R A P
AU - Papadimitrou, M
AU - Ritz, E
AU - Tsakiris, D
AU - MacLeod, A M
PY - 2000
Y1 - 2000
N2 - Background. There are wide national and international variations in the management of patients with endstage renal disease (ESRD). The aim of this study was to develop, harmonize, implement, and evaluate consensus-based clinical guidelines for the management of renal anaemia and renal bone disease in patients with ESRD, and for the prevention and management of cytomegalovirus disease in renal transplant recipients across six renal centres in Europe.Methods. The trial was a prospective, multicentre, randomized balanced incomplete block design. Nephrologists from the six European renal units were randomized to develop and implement guidelines for two out of the three conditions and to act as a control for the third condition. Data were collected pre- (1 year) and post- (9 months) intervention on aspects of patient monitoring, management, and outcome.Results. Eight hundred and twenty-nine dialysis patients from the six European dialysis centres were included in the study. Multivariate analysis (adjusting for case-mix and secular trends) showed a significant increase in the number of monitoring events in the guideline group compared with control group (6%, 95% CI, 1-11%). There was no concomitant increase in either appropriate management or the number of favourable patient outcomes.Conclusions. In the first European collaboration on renal guidelines, the introduction of the guidelines improved the monitoring of the patients, but did not improve patient management or outcome. This study suggests the potential for creating clinical guidelines with the aim of standardizing treatment protocols across international boundaries, and improving the quality of the medical care provided.
AB - Background. There are wide national and international variations in the management of patients with endstage renal disease (ESRD). The aim of this study was to develop, harmonize, implement, and evaluate consensus-based clinical guidelines for the management of renal anaemia and renal bone disease in patients with ESRD, and for the prevention and management of cytomegalovirus disease in renal transplant recipients across six renal centres in Europe.Methods. The trial was a prospective, multicentre, randomized balanced incomplete block design. Nephrologists from the six European renal units were randomized to develop and implement guidelines for two out of the three conditions and to act as a control for the third condition. Data were collected pre- (1 year) and post- (9 months) intervention on aspects of patient monitoring, management, and outcome.Results. Eight hundred and twenty-nine dialysis patients from the six European dialysis centres were included in the study. Multivariate analysis (adjusting for case-mix and secular trends) showed a significant increase in the number of monitoring events in the guideline group compared with control group (6%, 95% CI, 1-11%). There was no concomitant increase in either appropriate management or the number of favourable patient outcomes.Conclusions. In the first European collaboration on renal guidelines, the introduction of the guidelines improved the monitoring of the patients, but did not improve patient management or outcome. This study suggests the potential for creating clinical guidelines with the aim of standardizing treatment protocols across international boundaries, and improving the quality of the medical care provided.
KW - CAPD
KW - clinical guidelines
KW - cluster randomized trial
KW - European guidelines
KW - haemodialysis
KW - REPLACEMENT THERAPY
KW - OUTCOMES
M3 - Article
VL - 15
SP - 1394
EP - 1398
JO - Nephrology Dialysis Transplantation
JF - Nephrology Dialysis Transplantation
SN - 0931-0509
ER -