NFK Spring Clinical Meetings 2021
Amy Larkin, PharmD, and Donald Blatherwick of Medscape Education, New York, New York, examined an intervention based mostly on digital affected person simulation (VPS) designed to enhance the efficiency of nephrologists associated to identification of sufferers with, and persistent administration of, hyperkalemia. Results have been reported throughout a digital poster session on the NFK Spring Clinical Meetings 2021 in a poster titled Success of Virtual Patient Simulation at Improving Management of Chronic Hyperkalemia.
The intervention comprised a affected person presenting at two totally different cut-off dates in a VPS platform permitting learners to order laboratory checks, make diagnoses, and prescribe remedies in a fashion designed to match the scope and depth of precise observe. Current proof and proposals have been used to develop tailor-made medical steerage (CG) supplied after every determination; the learner was then supplied the chance to modify selections. Following the CG, selections have been collected and in contrast with every consumer’s baseline selections (pre-CG). P values have been decided utilizing a 2-tailed paired t-test, The exercise was posted August 30, 2019; preliminary knowledge have been collected by November 7, 2019.
At the time of the poster presentation, 40 nephrologists who had accomplished the exercise (completion was outlined as offering all selections inside no less than one case) have been included within the outcomes evaluation:
Initial go to:
- Diagnosis of CKD stage 32: 3% pre-CG versus 45% submit CG; 43% absolute enchancment; P<.01
- Diagnosis of hyperkalemia: 50% pre-CG versus 70% post-CG; 20% absolute enchancment; P<.01
- Initiation of a potassium binder: 30% pre-CG versus 73% post-CG; 43% enchancment; P<.01
- Initiation of a renin-angiotensin-aldosterone (RAAS) inhibitor: 35% pre-CHG versus 73% post-CG; 38% enchancment; P<.01
- Initiation of a sodium-glucose co-transporter-2 inhibitor or glucagon-like peptide-1 receptor agonist: 78% pre-CG versus 83% post-CG; 5% enchancment; P=.16.
Follow-up go to:
- Initiation of a potassium binder: 28% pre-CG versus 66% post-CG; 38% Improvement; P<.01
- Initiation of a loop diuretic: 69% pre-CG versus 97% post-CG; 28% Improvement; P<.01
- Initiation of a mineralocorticoid receptor antagonist: 0% pre-CG versus 38% post-CG; 38% enchancment; P<.01
- Initiation of a RAAS inhibitor: 90% pre-CG versus 93% post-CG; 3% enchancment; P=.33
In conclusion, the authors stated, “VPS that immerses and engages specialists in an genuine and sensible studying expertise can enhance evidence-based medical selections associated to affected person identification and administration of hyperkalemia.”
Source: Larkin, Blatherwick D. Success of digital affected person simulation at enhancing administration of persistent hyperkalemia. Abstract of a poster offered on the National Kidney Foundation digital Spring Clinical Meetings 2021 (Abstract #271), April 9, 2021.