scholarly journals Outcomes of a 12-month patient-centred medical home model in improving patient activation and self-management behaviours among primary care patients presenting with chronic diseases in Sydney, Australia: A before-and-after study.

2020 ◽  
Author(s):  
James John ◽  
Kathy Tannous ◽  
Amanda Jones
Keyword(s):  
Chronic Diseases ◽  
Medical Home ◽  
Multivariate Regression ◽  
Regression Models ◽  
Patient Activation ◽  
Self Management ◽  
Before And After ◽  
General Practices ◽  
Sydney Australia

Abstract Background: Studies report that increased patient activation is associated with increased patient engagement with the health care system, better adherence to treatment protocols, and improved health outcomes. This study aims to evaluate outcomes based on a 12-month Patient-Centred Medical Home (PCMH) model called ‘WellNet’ on activation levels of patients with one or more chronic diseases in general practices across Sydney, Australia.Methods: A total of 636 patients aged 40 years and above with one or more chronic conditions consented to participate in the WellNet program delivered across six general practices in Northern Sydney, Australia. The WellNet treatment includes a team-based care with general physicians and trained chronic disease management care coordinators collaborating with patients in designing a patient-tailored care plan with improved self-management support and care navigation according to the level of risk and health care needs. Level of patient activation was measured using the validated PAM 13-item scale at baseline and follow-up. A before and after case-series design was employed to determine adjusted differences between baseline and 12-months using repeated measures analysis of covariance (ANCOVA). Multiple imputation was used to compute missing follow-up scores using Markov Chain Monte Carlo (MCMC) algorithm known as fully conditional specification (FCS). Additionally, backward stepwise multivariate regression models were employed to identify significant predictors of activation at follow-up.Results: Of the 626 patients, 420 reported their PAM scores at follow-up. The mean (SD) baseline PAM score was 57.9 (13.0). The adjusted model showed significant mean difference in PAM scores of 6.5 (95% CI 5.0-8.1; p-value<0.001) after controlling for baseline covariates. Multivariate regression models showed that older age (B = -0.14; 95% CI -0.28, -0.01), baseline activation score (B = 0.48; 95% CI 0.37, 0.59), and private insurance (uninsured patients) (B = -3.41; 95% CI -6.50, -0.32) were significant predictors of patient activation at follow-up.Conclusion: The WellNet study is the first of its kind in Australia to report on changes in the patient activation levels among patients with one or more chronic diseases. PCMH has the potential to improve patient activation and engagement which can lead to long-term health benefits and sustained self-management behaviours.

scholarly journals Outcomes of a 12-month patient-centred medical home model in improving patient activation and self-management behaviours among primary care patients presenting with chronic diseases in Sydney, Australia: A before-and-after study.

2020 ◽  
Author(s):  
James John ◽  
Kathy Tannous ◽  
Amanda Jones
Keyword(s):  
Chronic Diseases ◽  
Medical Home ◽  
Multivariate Regression ◽  
Regression Models ◽  
Patient Activation ◽  
Self Management ◽  
Before And After ◽  
General Practices ◽  
Sydney Australia

Abstract Background: Studies report that increased levels of patient activation is associated with increased engagement with the health care system, better adherence to treatment protocols, and improved health outcomes. This study aims to evaluate outcomes based on a 12-month Patient-Centred Medical Home (PCMH) model called ‘WellNet’ on activation levels of patients with one or more chronic diseases in general practices across Sydney, Australia.Methods: A total of 636 patients aged 40 years and above with one or more chronic conditions consented to participate in the WellNet program delivered across six general practices in Northern Sydney, Australia. The WellNet intervention includes a team-based care with general physicians and trained chronic disease management care coordinators collaborating with patients in designing a patient-tailored care plan with improved self-management support and care navigation according to the level of risk and health care needs. Level of patient activation was measured using the validated PAM 13-item scale at baseline and follow-up. A before and after case-series design was employed to determine adjusted differences between baseline and 12-months using repeated measures analysis of covariance (ANCOVA). Additionally, backward stepwise multivariate regression models were employed to identify significant predictors of activation at follow-up.Results: Of the 626 patients, 420 reported their PAM scores at follow-up. The mean (SD) baseline PAM score was 57.9 (13.0). The adjusted model showed significant mean difference in PAM scores of 6.5 (95% CI 5.0-8.1; p-value<0.001) after controlling for baseline covariates. Multivariate regression models showed that older age (B = -0.14; 95% CI -0.28, -0.01) and private insurance (uninsured patients) (B = -3.41; 95% CI -6.50, -0.32) were significantly associated with lower PAM scores at 12 months whereas higher baseline PAM scores (B = 0.48; 95% CI 0.37, 0.59) was significantly associated with higher follow-up PAM scores.Conclusion: The WellNet study is the first of its kind in Australia to report on changes in the patient activation levels among patients with one or more chronic diseases. PCMH has the potential to improve patient activation and engagement which can lead to long-term health benefits and sustained self-management behaviours.

scholarly journals Outcomes of a 12-month patient-centred medical home model on patient activation and self-management behaviours among primary care patients presenting with chronic diseases in Sydney, Australia.

2020 ◽  
Author(s):  
James John ◽  
Kathy Tannous ◽  
Amanda Jones
Keyword(s):  
Health Care ◽  
Medical Home ◽  
Multivariate Regression ◽  
Regression Models ◽  
Patient Activation ◽  
Self Management ◽  
Medical Home Model ◽  
General Practices ◽  
Sydney Australia

Abstract Background: Patient activation is an important precursor not only for effective self-management of chronic comorbidity but also to empower patients in actively making decisions concerning their health. Studies report that increased activation in terms of high patient activation measure (PAM) scores are associated with increased patient engagement with the health care system, better compliance to treatment protocols, and improved health outcomes. This study aims to evaluate outcomes of Patient-Centred Medical Home model called ‘WellNet’ on activation levels of patients with multimorbidity in general practices across Sydney, Australia. Methods: A total of 636 patients consented to participate in the WellNet program delivered across six general practices in Northern Sydney, Australia. The WellNet treatment comprised of a team-based care with General Physicians collaborating with trained Chronic Disease Management care coordinators. After a comprehensive assessment, the care team designed patient-tailored care plan with self-management support and care navigation according to the level of risk and health care needs. Level of patient activation was measured using the validated PAM 13-item scale at baseline and follow-up. A case-series design was employed to determine significant differences between baseline and 12-months using General Linear Models. Multiple imputation was used to compute missing follow-up scores using Markov Chain Monte Carlo (MCMC) algorithm known as fully conditional specification (FCS). Multivariate regression models were employed to identify significant predictors of activation at follow-up. Results: Of the 626 patients, 420 reported their PAM levels at follow-up. The adjusted model showed significant mean difference in PAM scores of 6.5 (95%CI 5.0-8.1; p-value<0.001) after controlling for baseline covariates. Multivariate regression models determined that older age (OR = -0.14; 95% CI -0.28, -0.01), baseline activation score (OR = 0.48; 95% CI 0.37, 0.59), and private insurance (uninsured patients) (OR = -3.41; 95% CI -6.50, -0.32) were significant predictors of patient activation at follow-up. Conclusion: The WellNet study is the first of its kind in Australia to report on changes in the activation and self-management among patients with multimorbidity. PCMH has the potential to improve patient activation and engagement which can lead to long-term health benefits and sustained self-management behaviours.

scholarly journals Outcomes of a 12-month patient-centred medical home model in improving patient activation and self-management behaviours among primary care patients presenting with chronic diseases in Sydney, Australia: A before-and-after study.

2020 ◽  
Author(s):  
James John ◽  
W Kathy Tannous ◽  
Amanda Jones
Keyword(s):  
Chronic Diseases ◽  
Regression Models ◽  
Patient Activation ◽  
Self Management ◽  
Before And After ◽  
Multivariable Regression ◽  
General Practices ◽  
Multivariable Regression Models ◽  
Sydney Australia

Abstract Background: Studies report that increased levels of patient activation is associated with increased engagement with the health care system, better adherence to treatment protocols, and improved health outcomes. This study aims to evaluate the outcomes of a 12-month Patient-Centred Medical Home (PCMH) model called ‘WellNet’ on the activation levels of patients with one or more chronic diseases in general practices across Northern Sydney, Australia.Methods: A total of 636 patients aged 40 years and above with one or more chronic conditions consented to participate in the WellNet program which was delivered across six general practices in Northern Sydney, Australia. The WellNet intervention includes team-based care with general physicians and trained chronic disease management care coordinators collaborating with patients in designing a patient-tailored care plan with improved self-management support and care navigation according to the level of risk and health care needs. The level of patient activation was measured using the validated PAM 13-item scale at baseline and follow-up. A before and after case-series design was employed to determine the adjusted mean differences between baseline and 12-months using repeated measures analysis of covariance (ANCOVA). Additionally, the backward stepwise multivariable regression models were employed to identify significant predictors of activation at follow-up.Results: Of the 626 patients, 420 reported their PAM scores at follow-up. The mean (SD) baseline PAM score was 57.9 (13.0). The adjusted model showed significant mean difference in PAM scores by increase of 6.5 (95% CI 5.0-8.1; p-value<0.001) after controlling for baseline covariates. The multivariable regression models showed that older age (B = -0.14; 95% CI -0.28, -0.01) and private insurance (uninsured patients) (B = -3.41; 95% CI -6.50, -0.32) were significantly associated with lower PAM scores at 12 months whereas higher baseline PAM score (B = 0.48; 95% CI 0.37, 0.59) was significantly associated with higher follow-up PAM score.Conclusion: The WellNet study is the first of its kind in Australia to report on changes in the patient activation levels among patients with one or more chronic diseases. PCMH has the potential to improve patient activation and engagement which can lead to long-term health benefits and sustained self-management behaviours.

Cohort Profile: Effectiveness of a 12-month patient-centred medical home model of primary care versus standard care for chronic disease management of high risk patients in Sydney, Australia

2019 ◽  
Author(s):  
James Rufus John ◽  
Amanda Jones ◽  
Munro Neville ◽  
Shima Ghassempour ◽  
Federico Girosi ◽  
...  
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Clinical Outcomes ◽  
Chronic Diseases ◽  
Medical Home ◽  
Comparison Group ◽  
Risk Patients ◽  
General Practices ◽  
Clinical Measures ◽  
Sydney Australia

Abstract Background: Patients presenting with multiple chronic conditions have complex healthcare needs that are challenging to manage in primary care. This paper aims to evaluate the effectiveness of a patient-centred medical home (PCMH) model for improving clinical outcomes in high risk patients in Sydney, Australia. Methods: A cohort study design with a comparison group and a case-series study design were used to evaluate ‘between-group’ and ‘within-group’ effectiveness of a 12-month PCMH treatment called ‘WellNet’ delivered across several general practices in Sydney, Australia. The intervention group consists of 636 eligible participants who had been diagnosed with one or more chronic diseases and/or one or more elevated clinical risk factors; and had a Hospital Admission Risk Profile (HARP) score of greater than 10 at study enrolment between October 2016 and October 2017. The comparison group consists of 7750 randomly selected and well-matched patients receiving usual general practice (GP) care at four geographically comparable general practices in Sydney. Data collected from the general practices include socio-demographics; clinical measures; and self-completed health surveys. Outcomes include 12-month changes in clinical outcomes and patient reported general and disease-specific health assessments. Paired sample t-test and independent samples t-test will be used to determine significant ‘within-group’ and ‘between-group’ differences respectively. In addition, analysis of covariance (ANCOVA) and repeated measures ANCOVA will be used to determine any differences in the clinical measures and assessments after adjusting for covariates such as age, gender and baseline values. Discussion: To our knowledge, the WellNet study is the first study in Australia to generate evidence on the feasibility of recruitment, retention, and adherence into, as well as effectiveness of a comprehensive PCMH model using GP-based data. Baseline findings show that mean age of the study participants was 70.05 years with nearly even gender distribution of males and females. The most prevalent chronic diseases in descending order were: circulatory system disorders (69.8%), diabetes (47.4%), musculoskeletal disorders (43.5%), respiratory diseases (28.7%), mental illness (18.8%), and cancer (13.6%). Findings of this study may be beneficial to both patients and providers in terms of improved health outcomes, shared-decision making, and increased satisfaction in delivery of care respectively.

Effect of the Containment Type on Clinical Outcomes in Osteochondral Lesions of the Talus Treated With Autologous Osteochondral Transplantation

2018 ◽  
Vol 46 (9) ◽  
pp. 2096-2102 ◽  
Author(s):  
Yoshiharu Shimozono ◽  
Johanna C.E. Donders ◽  
Youichi Yasui ◽  
Eoghan T. Hurley ◽  
Timothy W. Deyer ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Clinical Outcomes ◽  
Multivariate Regression ◽  
Regression Models ◽  
Short Form ◽  
Osteochondral Lesions ◽  
Osteochondral Transplantation ◽  
Autologous Osteochondral Transplantation ◽  
Type Group

Background: Uncontained-type osteochondral lesions of the talus (OLTs) have been shown to have inferior clinical outcomes after treatment with bone marrow stimulation. While autologous osteochondral transplantation (AOT) is indicated for larger lesions, no study has reported on the prognostic significance of the containment of OLTs treated with the AOT procedure. Purpose: To clarify the effect of the containment of OLTs on clinical and radiological outcomes in patients who underwent AOT for OLTs. Study Design: Case control study; Level of evidence, 3. Methods: A retrospective cohort study comparing patients with contained-type and uncontained-type OLTs was undertaken to include all patients who underwent AOT for the treatment of OLTs between 2006 and 2014. Analyses were performed by grouping the patients according to the containment type. Clinical outcomes were evaluated using the Foot and Ankle Outcome Score (FAOS) and the 12-Item Short Form Health Survey (SF-12) preoperatively and at final follow-up. Magnetic resonance imaging (MRI) at 2 years’ follow-up was evaluated with the modified magnetic resonance observation of cartilage repair tissue (MOCART) score. Multivariate regression models were used to evaluate factors affecting postoperative FAOS, SF-12, and MOCART scores. Results: Ninety-four patients were included: 31 patients with a contained-type OLT and 63 patients with an uncontained-type OLT. The median patient age was 34 years (interquartile range [IQR], 28-48 years) in the contained-type group and 36 years (IQR, 27-46 years) in the uncontained-type group. The median follow-up time was 45 months (IQR, 38-63 months) in the contained-type group and 52 months (IQR, 40-66 months) in the uncontained-type group. The median FAOS and SF-12 scores improved significantly after surgery in both contained-type and uncontained-type lesions ( P < .001). The median postoperative FAOS score of patients with contained-type OLTs was higher than that of patients with uncontained-type OLTs (91.7 vs 85.0, respectively; P = .009), but no significant differences were found between the contained-type and uncontained-type groups for postoperative SF-12 and MOCART scores. The multivariate regression models showed that patients with contained-type OLTs had an approximately 10-point better score on the FAOS compared with patients with uncontained-type OLTs ( P = .006). There was a nonsignificant trend for the rate of cystic occurrence in uncontained-type OLTs to be higher than that of contained-type OLTs (55.6% vs 38.7%, respectively; P = .125). Conclusion: Patients with contained-type OLTs experienced better clinical outcomes than those with uncontained-type OLTs after AOT for the treatment of OLTs. However, the AOT procedure still provided good clinical and MRI outcomes in both contained-type and uncontained-type OLTs at midterm follow-up.

scholarly journals A 2-Month Follow-Up Study of Psychological Distress among Italian People during the COVID-19 Lockdown

2020 ◽  
Vol 17 (21) ◽  
pp. 8180 ◽  
Author(s):  
Paolo Roma ◽  
Merylin Monaro ◽  
Marco Colasanti ◽  
Eleonora Ricci ◽  
Silvia Biondi ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Coping Strategies ◽  
Multivariate Regression ◽  
Regression Models ◽  
Anxiety And Depression ◽  
Factors Associated ◽  
Younger Age ◽  
Post Traumatic ◽  
Traumatic Symptoms

The spread of coronavirus disease 2019 (COVID-19) has called for unprecedented measures, including a national lockdown in Italy. The present study aimed at identifying psychological changes (e.g., changes in depression, stress, and anxiety levels) among the Italian public during the lockdown period, in addition to factors associated with these changes. An online follow-up survey was administered to 439 participants (original sample = 2766), between 28 April and 3 May 2020. A paired sample t-test tested for differences in stress, anxiety, and depression over the period. Multivariate regression models examined associations between sociodemographic variables, personality traits, coping strategies, depression, and stress. Results showed an increase in stress and depression over the lockdown, but not anxiety. Negative affect and detachment were associated with higher levels of depression and stress. Higher levels of depression at the start of the lockdown, as well as fewer coping strategies and childlessness, were associated with increased depression at follow-up, whereas higher levels of stress at the start of the lockdown and younger age were associated with higher stress at follow-up. These results may help us to identify persons at greater risk of suffering from psychological distress as a result lockdown conditions, and inform psychological interventions targeting post-traumatic symptoms.

Self-Management Behaviours and Change in Frailty Status among Community-Dwelling Older Adults: A National Longitudinal Population-based Cohort Study

2022 ◽  
Author(s):  
Thi Lien To ◽  
Ching-Pyng Kuo ◽  
Chih-Jung Yeh ◽  
Wen-Chun Liao ◽  
Meng-Chih Lee
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Chronic Diseases ◽  
Community Dwelling ◽  
Self Management ◽  
Geriatric Syndrome ◽  
Frailty Phenotype ◽  
Frailty Status ◽  
Community Dwelling Older Adults

Abstract Background: Frailty in older adults is a common geriatric syndrome that can be reversed, thus coping strategies for the aging population are essential. Self-management behaviours may represent cost-effective strategies to reverse physical frailty in community-dwelling older adults. This study aimed to describe the changes in frailty status among community-dwelling older adults in Taiwan and investigate the association of self-management behaviours with changes in frailty status over a four-year follow-up period (2007 to 2011).Methods: This data was retrieved from the Taiwan Longitudinal Study of Aging (TLSA), which is a prospective cohort study of 1,283 community-dwelling older adults aged 65 years and older without cognitive impairment. Frailty was assessed based on Fried's frailty phenotype, in which ≥ three criteria indicate frail. Self-management behaviours (maintaining body weight, quitting smoking, drinking less, exercising, diet control, and maintaining a regular lifestyle) were assessed using a questionnaire. Multivariate logistic regression analyses were used to investigate the associations between self-management behaviours and changes in frailty status.Results: The prevalence of frailty was 8.7% at baseline and 8.1% after four years of follow-up, with 196 (15.3%) deaths. Overall, 74.6% of participants remained in the same state (non-frail or frail), 23.5% worsened (non-frail to frail, including missing data, and frail to death), and only 1.95% improved (frail to non-frail). Being aged ≥ 75-years-old, chronic diseases, and an absence of self-management behaviours were associated with higher risks of frailty at baseline and after follow-up. Exercise was significantly associated with a reversal of frailty in community-dwelling older adults (RR, 3.11; 95% CI, 1.95, 4.95) after adjusting for personal and disease covariates, regardless of whether death was coded as frail or not.Conclusions: Self-management behaviours beneficially reverse frailty status; maintaining regular exercise was especially associated with a reversal of frailty in community-dwelling older adults, even among individuals over 75-years-old and with chronic diseases. Older adults should be encouraged to perform adequate physical exercise to prevent the progression of frailty and ameliorate frailty status.

scholarly journals Cohort Profile: Effectiveness of a 12-Month Patient-Centred Medical Home Model Versus Standard Care for Chronic Disease Management among Primary Care Patients in Sydney, Australia

2020 ◽  
Vol 17 (6) ◽  
pp. 2164 ◽  
Author(s):  
James Rufus John ◽  
Amanda Jones ◽  
A. Munro Neville ◽  
Shima Ghassempour ◽  
Federico Girosi ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Disease Management ◽  
Chronic Diseases ◽  
Medical Home ◽  
Chronic Disease Management ◽  
Intervention Group ◽  
Lessons Learned ◽  
Management Support ◽  
Sydney Australia

Evidence suggests that patient-centred medical home (PCMH) is more effective than standard general practitioner care in improving patient outcomes in primary care. This paper reports on the design, early implementation experiences, and early findings of the 12-month PCMH model called ‘WellNet’ delivered across six primary care practices in Sydney, Australia. The WellNet study sample comprises 589 consented participants in the intervention group receiving enhanced primary care in the form of patient-tailored chronic disease management plan, improved self-management support, and regular monitoring by general practitioners (GPs) and trained clinical coordinators. The comparison group consisted of 7750 patients who were matched based on age, gender, type and number of chronic diseases who received standard GP care. Data collected include sociodemographic characteristics, clinical measures, and self-reported health assessments at baseline and 12 months. Early study findings show the mean age of the study participants was 70 years with nearly even gender distribution of males (49.7%) and females (50.3%). The most prevalent chronic diseases in descending order were circulatory system disorders (69.8%), diabetes (47.4%), musculoskeletal disorders (43.5%), respiratory diseases (28.7%), mental illness (18.8%), and cancer (13.6%). To our knowledge, the WellNet study is the first study in Australia to generate evidence on the feasibility of design, recruitment, and implementation of a comprehensive PCMH model. Lessons learned from WellNet study may inform other medical home models in Australian primary care settings.

scholarly journals MO470PATIROMER PHARMACOUTILIZATION IN REAL-WORLD GERMAN CKD PATIENTS WITH MODERATELY TO SEVERELY REDUCED EGFR

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Roberto Pecoits-Filho ◽  
Daniel Muenz ◽  
K P McCullough ◽  
Johannes Duttlinger ◽  
Viviane Calice-Siva ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Real World ◽  
Regression Models ◽  
High Serum ◽  
High Morbidity ◽  
Logistic Regression Models ◽  
Ckd Stage ◽  
Before And After ◽  
Lower Egfr

Abstract Background and Aims Hyperkalemia (HK) (serum K&gt;5.0 mEq/L) is a chronic condition in patients with chronic kidney disease (CKD) associated with high morbidity and mortality, and it is a frequent reasons for renin angiotensin aldosterone inhibition (RAASi) discontinuation. Patiromer is a non-absorbed, sodium-free, K+ binder that has been shown to reduce serum K+ in patients with HK, and thereby enable RAASi therapy, which is supported by randomized trial evidence. The description of patiromer utilization in patients with moderate to advanced CKD in the real-world setting in Europe is lacking. The objective of this analysis was to describe predictors of patiromer initiation and time to discontinuation among CKD patients using contemporary (April 2018-October 2020) data from German participants in CKD Outcomes and Practice Patterns Study (CKDopps). Method We identified 136 patiromer users (116 with matching K measurement) during the observation period. Patients with eGFR &lt;60ml/min/1.73m2 and a serum potassium ≥4mEq/L who never initiated patiromer during the follow up were used as a comparison. We used the most recent lab and drug use information available within the 6-month period prior to baseline, which was defined as either first use of patiromer, April 1, 2018, or entry into the PDOPPS study. The median time between the most recent K+ measurement and baseline was 45 days for non-patiromer users and 4 days for patiromer users. Logistic regression models were used to test associations between patient factors and whether the patient was in the patiromer initiation group or the comparison group. Time on patiromer was estimated using a Kaplan-Meier curve, censoring for death, dialysis, transplantation, or loss of follow-up. Results Patiromer was prescribed to ≥2 patients in 11 clinics, one patient in 19 clinics, and zero patients in 57 clinics. Patients prescribed patiromer had lower eGFR (23.2 [15.8, 28.6] vs 36.9 [27.7, 46.3]ml/min) and higher serum K levels (5.6 [5.4, 6.1] vs 4.6 [4.3, 5.0]ml/min). There were no major differences according to patiromer use in other demographic, clinical, and biochemical characteristics. Despite the differences in serum K, use of RAAS inhibitors was similar in patiromer users (83%) versus non-users (80%). Thirty three percent of patiromer users were prescribed polystyrene sulfonate (SPS) before patiromer initiation. In a multiple logistic regression models (including serum K, CKD stage, gender, age, prescription of RAASi, diabetes, coronary artery disease, heart failure), patiromer use was strongly associated more advanced CKD stage (independently of high serum K), with odds ratios of initiation &gt;3 for CKD stage 4 or 5 versus CKD stage 3. Among new users, 90% of patients had active prescription at 30 days and about one-half had active prescription at one year (Figure). Conclusion The main predictors of Patiromer initiation were advanced CKD stage and hyperkalemia. Treatment decisions did not appear to be based on other patient or clinical characteristics. Patiromer was often prescribed to patients already receiving alternative HK treatment (SPS), suggesting use for chronic hyperkalemia rather than response to acute event. Further analysis with a larger population and measurements of K+ before and after patiromer initiation may improve the understanding of its pharmacoutilization in moderate to advanced CKD.

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