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Patient-Reported Safety Events in Chronic Kidney Disease Recorded With an Interactive Voice-Inquiry Dial-Response System: Monthly Report Analysis.

Publication ,  Journal Article
Fink, JC; Doerfler, RM; Yoffe, MR; Diamantidis, CJ; Blumenthal, JB; Siddiqui, T; Gardner, JF; Snitker, S; Zhan, M
Published in: J Med Internet Res
May 26, 2016

BACKGROUND: Monitoring patient-reported outcomes (PROs) may improve safety of chronic kidney disease (CKD) patients. OBJECTIVE: Evaluate the performance of an interactive voice-inquiry dial-response system (IVRDS) in detecting CKD-pertinent adverse safety events outside of the clinical environment and compare the incidence of events using the IVDRS to that detected by paper diary. METHODS: This was a 6-month study of Stage III-V CKD patients in the Safe Kidney Care (SKC) study. Participants crossed over from a paper diary to the IVDRS for recording patient-reported safety events defined as symptoms or events attributable to medications or care. The IVDRS was adapted from the SKC paper diary to record event frequency and remediation. Participants were auto-called weekly and permitted to self-initiate calls. Monthly reports were reviewed by two physician adjudicators for their clinical significance. RESULTS: 52 participants were followed over a total of 1384 weeks. 28 out of 52 participants (54%) reported events using the IVDRS versus 8 out of 52 (15%) with the paper diary; hypoglycemia was the most common event for both methods. All IVDRS menu options were selected at least once except for confusion and rash. Events were reported on 121 calls, with 8 calls reporting event remediation by ambulance or emergency room (ER) visit. The event rate with the IVDRS and paper diary, with and without hypoglycemia, was 26.7 versus 4.7 and 18.3 versus 0.8 per 100 person weeks, respectively (P=.002 and P<.001). The frequent users (ie, >10 events) largely differed by method, and event rates excluding the most frequent user of each were 16.9 versus 2.5 per 100 person weeks, respectively (P<.001). Adjudicators found approximately half the 80 reports clinically significant, with about a quarter judged as actionable. Hypoglycemia was often associated with additional reports of fatigue and falling. Participants expressed favorable satisfaction with the IVDRS. CONCLUSIONS: Use of the IVDRS among CKD patients reveals a high frequency of clinically significant safety events and has the potential to be used as an important supplement to clinical care for improving patient safety.

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Published In

J Med Internet Res

DOI

EISSN

1438-8871

Publication Date

May 26, 2016

Volume

18

Issue

5

Start / End Page

e125

Location

Canada

Related Subject Headings

  • Self Report
  • Renal Insufficiency, Chronic
  • Patient Safety
  • Middle Aged
  • Medical Informatics
  • Humans
  • Female
  • Cohort Studies
  • Aged
  • Adult
 

Citation

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Fink, J. C., Doerfler, R. M., Yoffe, M. R., Diamantidis, C. J., Blumenthal, J. B., Siddiqui, T., … Zhan, M. (2016). Patient-Reported Safety Events in Chronic Kidney Disease Recorded With an Interactive Voice-Inquiry Dial-Response System: Monthly Report Analysis. J Med Internet Res, 18(5), e125. https://doi.org/10.2196/jmir.5203
Fink, Jeffrey C., Rebecca M. Doerfler, Marni R. Yoffe, Clarissa J. Diamantidis, Jacob B. Blumenthal, Tariq Siddiqui, James F. Gardner, Soren Snitker, and Min Zhan. “Patient-Reported Safety Events in Chronic Kidney Disease Recorded With an Interactive Voice-Inquiry Dial-Response System: Monthly Report Analysis.J Med Internet Res 18, no. 5 (May 26, 2016): e125. https://doi.org/10.2196/jmir.5203.
Fink JC, Doerfler RM, Yoffe MR, Diamantidis CJ, Blumenthal JB, Siddiqui T, et al. Patient-Reported Safety Events in Chronic Kidney Disease Recorded With an Interactive Voice-Inquiry Dial-Response System: Monthly Report Analysis. J Med Internet Res. 2016 May 26;18(5):e125.
Fink, Jeffrey C., et al. “Patient-Reported Safety Events in Chronic Kidney Disease Recorded With an Interactive Voice-Inquiry Dial-Response System: Monthly Report Analysis.J Med Internet Res, vol. 18, no. 5, May 2016, p. e125. Pubmed, doi:10.2196/jmir.5203.
Fink JC, Doerfler RM, Yoffe MR, Diamantidis CJ, Blumenthal JB, Siddiqui T, Gardner JF, Snitker S, Zhan M. Patient-Reported Safety Events in Chronic Kidney Disease Recorded With an Interactive Voice-Inquiry Dial-Response System: Monthly Report Analysis. J Med Internet Res. 2016 May 26;18(5):e125.

Published In

J Med Internet Res

DOI

EISSN

1438-8871

Publication Date

May 26, 2016

Volume

18

Issue

5

Start / End Page

e125

Location

Canada

Related Subject Headings

  • Self Report
  • Renal Insufficiency, Chronic
  • Patient Safety
  • Middle Aged
  • Medical Informatics
  • Humans
  • Female
  • Cohort Studies
  • Aged
  • Adult