Official websites use. Share sensitive information only on official, secure websites. Corresponding author. Pape uk-essen. The program provided a multimodal aftercare program including specialized case management, telemedicine support, psychological and exercise assessments, and interventions. For the analysis of graft failure, which was defined as death, re-transplantation or start of long-term dialysis, we used longitudinal claims data from participating statutory health insurances SHI which enabled us to compare participants with controls.
To balance covariate distributions between these nonrandomized groups we used propensity score methodology, in particular the inverse probability of treatment weighting IPTW approach. Due to differences in the availability of the claims data, the claims data of participants and controls could be used for the analyses. Our findings suggest that a multimodal and multidisciplinary aftercare intervention can significantly improve outcome after KTx, specifically in patients later after KTx.
For evaluation of effects on these outcome parameters in patients enrolled within the first year after transplantation longer observation times are necessary. The claims data analysis suggests that a multimodal aftercare program, including specialized case management, telemedicine support, psychosocial and exercise assessments, and interventions can improve graft and patient survival in prevalent transplant patients.
Our study was the first prospectively conducted study that established a multimodal aftercare program after kidney transplantation. In longitudinal claims data analysis from prevalent patients we could demonstrate significantly improved patient and transplant survival. In the first year after transplantation the event rate was too low and follow-up time was too short to discover any beneficial effect on patient and transplant survival.
For the majority of patients with end-stage renal disease ESRD , the best form of therapy is a kidney transplantation KTx , since it is associated with significantly reduced morbidity and mortality compared to dialysis. Also, graft survival is better in physically active patients compared to patients less involved in physical activity. Even though we are in the era of digitalization, post-transplant care in Germany is not systematically digitalized and most health data are still exchanged via mail and fax with significant delays.
