Evaluation of clinical guidelines for the management of end-stage renal disease in Europe: the EU BIOMED 1 Study

C R Ramsay, M K Campbell, D Cantarovich, G Catto, J Cody, C Daly, C Delcroix, N Edward, J M Grimshaw, H W van Hamersvelt, I S Henderson, I H Khan, R A P Koene, M Papadimitrou, E Ritz, D Tsakiris, A M MacLeod

Research output: Contribution to journalArticle

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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 languageEnglish
Pages (from-to)1394-1398
Number of pages5
JournalNephrology Dialysis Transplantation
Volume15
Publication statusPublished - 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 journalArticle

Ramsay, CR, Campbell, MK, Cantarovich, D, Catto, G, Cody, J, Daly, C, Delcroix, C, Edward, N, Grimshaw, JM, van Hamersvelt, HW, Henderson, IS, Khan, IH, Koene, RAP, Papadimitrou, M, Ritz, E, Tsakiris, D & MacLeod, AM 2000, 'Evaluation of clinical guidelines for the management of end-stage renal disease in Europe: the EU BIOMED 1 Study', Nephrology Dialysis Transplantation, vol. 15, pp. 1394-1398.
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 . / Evaluation of clinical guidelines for the management of end-stage renal disease in Europe: the EU BIOMED 1 Study. In: Nephrology Dialysis Transplantation. 2000 ; Vol. 15. pp. 1394-1398.
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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.",
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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 -