title: Effectiveness of integrated care on delaying chronic kidney disease progression in rural communities of Thailand (ESCORT study): rationale and design of the study [NCT01978951].
abstract: BACKGROUND
  In developing countries, accessibility to specialists, and physician to patient contact time is limited. In Thailand, A unique community health service is provided by subdistrict health care officers and Village Health Volunteers (VHVs). If the personnel were trained on proper chronic kidney disease (CKD) care, CKD progression would be delayed.
  
  
  METHODS
  We conducted a community-based, cluster randomized controlled trial at Kamphaeng Phet Province, located about 400 kilometers north of Bangkok. Two out of eleven districts of the province were randomly selected. Approximatly 500 stage 3-4 CKD patients from 2 districts were enrolled. Patients in both groups will be treated with standard guidelines. The patients in intervention group were provided the additional treatments by multidisciplinary team in conjunction with community CKD care network (subdistrict health care officers and VHVs) which will provide group counseling during each hospital visit and quarterly home visits to monitor dietary protein and sodium intake, blood pressure measurement and drug compliance. Duration of the study is 2 years. The primary outcome is the difference of rate of eGFR decline. The secondary outcomes are laboratory parameters and incidence of clinical endpoints such as mortality rate and cardiovascular events, end-stage renal disease (ESRD), etc.
  
  
  CONCLUSIONS
  Insights of this study may set forth a new standard of community-based CKD care.
  
  
  BACKGROUND
  NCT01978951.
authors: Bhumirajanagarindra Kidney Institute, Bangkok, Thailand. teerayut065@yahoo.com.
authors: Teerayuth
authors: T
authors: Jiamjariyaporn
authors: Atiporn
authors: A
authors: Ingsathit
authors: Kriang
authors: K
authors: Tungsanga
authors: Chatri
authors: C
authors: Banchuin
authors: Kotcharat
authors: K
authors: Vipattawat
authors: Suphattra
authors: S
authors: Kanchanakorn
authors: Vinai
authors: V
authors: Leesmidt
authors: Watcharapong
authors: W
authors: Watcharasaksilp
authors: Akhathai
authors: A
authors: Saetie
authors: Chanida
authors: C
authors: Pachotikarn
authors: Sunard
authors: S
authors: Taechangam
authors: Tanyarat
authors: T
authors: Teerapornlertratt
authors: Teerachai
authors: T
authors: Chantarojsiri
authors: Visith
authors: V
authors: Sitprija
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019033:Delivery of Health Care, Integrated; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000628:therapy*; D012107:Research Design; D012424:Rural Population; D015996:Survival Rate; D013785:Thailand; D016896:Treatment Outcome; D055815:Young Adult