EFFECTIVENESS OF A RENAL PROTECTION PROGRAM IN PATIENTS WITH HYPERTENSION AND/OR DIABETES MELLITUS TYPE II IN COLOMBIA

Author(s)

Guarin NE1, Moreno JA1, Arévalo HO1, Muñoz-Galindo IM1, Diaz JA2
1Salud Total EPS, Bogotá D.C., Colombia, 2Universidad Nacional de Colombia, Bogotá D.C., Colombia

OBJECTIVES:  To evaluate the effectiveness of two programs of renal protection (intensive versus regular) in patients affiliated with a health insurer in Colombia. METHODS:  The results of an innovative model of renal protection (Program A - cases) were compared with those of a model of regular care (Program B - Controls), in patients with a diagnosis of hypertension (HT) and / or diabetes mellitus type II (DM) and chronic kidney disease (CKD) stages 3, 4 and 5 not on dialysis, neither with a history of transplantation. According to the Neatest Neighbor Matching methodology a pairing was performed, taking into account the following variables: diagnostic, gender, age, weight, height, months of membership and measurement period. For each patient of the 6100 beneficiaries of program A, 2 patients controls were selected from a cohort of 160000 individuals in the program B, who formed the control groups 1 and 2. Validation was conducted by evaluating correlation indexes of Pearson, Kendall and Spearman. The evaluation period was 2013 to 2015. The outcome measure was progression of CKD by the difference in the annual rate of glomerular filtration rate (GFR). Statistical analysis was performed using STATA 13®. RESULTS:  The mean difference of annual progression of CKD in patients for the program A was: 4.27 ml/min/m2 (95% CI 3.9, 4.64), for the Programme B control group one: -1.63 ml/min/m2 (95% CI -2.04, -1.22) and control group two: -1.49 ml/min/m2 (95% CI -1.9, -1.08). The annual difference of GFR in women of program A (HTA 6.31 ml/min/m2 - HTA and DM 4.83 ml/min/m2) was higher compared to men. CONCLUSIONS:  Patients of program A on average improve renal function, represented in positive difference in the TFG measures. Women and patients with diagnosed HT without concomitant DM recorded higher profits.

Conference/Value in Health Info

2016-10, ISPOR Europe 2016, Vienna, Austria

Value in Health, Vol. 19, No. 7 (November 2016)

Code

PHS8

Topic

Clinical Outcomes

Topic Subcategory

Comparative Effectiveness or Efficacy

Disease

Cardiovascular Disorders, Diabetes/Endocrine/Metabolic Disorders, Urinary/Kidney Disorders

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