Effects of a remote patient monitoring system for patients on automated peritoneal dialysis: a randomized crossover controlled trial

Uchiyama, Kiyotaka; Morimoto, Kohkichi; Washida, Naoki; Kusahana, Ei; Nakayama, Takashin; Itoh, Tateo; Kasai, Takahiro; Wakino, Shu; Itoh, Hiroshi

doi:10.1007/s11255-022-03178-5

Cited by 13 publications

(8 citation statements)

References 36 publications

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“…The use of RPM is associated with improved quality of life in children and adults [ 8 , 9 ]. A recent survey showed that 90% of patients/caregivers felt safe under RPM [ 9 ], although the scales on quality of life did not reflect an improvement in our cohort.…”

Section: Discussionmentioning

confidence: 99%

“…This system allows active monitoring of PD-related parameters, such as blood pressure and ultrafiltration, and remote adjustment of PD prescription. Limited trials involving adult patients generally showed improved patient satisfaction, but the benefits in clinical outcomes and reduction of medical visits remained controversial [ 7 , 8 ]. In the only available paediatric series, Bakkaloglu et al focused on the perceptions of RPM from families and health care providers [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes and perception of cloud-based remote patient monitoring in children receiving automated peritoneal dialysis: a prospective study

Chan¹,

Liu²,

Or³

et al. 2022

Pediatr Nephrol

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Background Remote patient monitoring (RPM) for automated peritoneal dialysis (APD) may improve clinical outcomes. Paediatric data, however, remain extremely scarce. Methods We conducted a prospective observational study of children (0–18 years) receiving APD with cloud-based RPM over two 24-week periods (pre- and post-RPM). Primary outcomes were unplanned hospitalizations and fluid management. Children receiving APD without RPM (non-RPM) were included as control. Results Seven patients (6 females) receiving APD were enrolled in the RPM programme at 11.3 years (IQR 2.6–17.1). Main indications for RPM included history of fluid overload ( n = 3) and non-adherence ( n = 2). Ten children were included in the non-RPM group (6 females; 16.9 years, IQR 12.8–17.6). Four patients (57.1%, 95% CI 22.5–100%) experienced fewer unplanned hospitalizations and 5 patients (71.4%, 95% CI 34.1–100%) had shorter hospital stays during the post-RPM period. The hospitalization rates and length of stay were reduced by 45% and 42%, respectively. The higher hospitalization rates among the RPM group, compared to the non-RPM group, were no longer observed following implementation of RPM. There was a significant increase in ultrafiltration (565.6 ± 248.7 vs. 501.7 ± 286.6 ml/day, p = 0.03) and reduction in systolic blood pressure (114.1 ± 12.6 vs. 119.9 ± 11.19 mmHg, p = 0.02) during the post-RPM period. All patients demonstrated satisfactory adherence. Although quality of life (PedsQL 3.0 ESRD module) was not different pre- and post-RPM, all patients agreed in the questionnaires that the use of RPM improved their quality of life and sense of security. Conclusions In conclusion, RPM in children receiving APD is associated with fewer and shorter unplanned hospitalizations, improved fluid management and favourable adherence to PD. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information Supplementary information The online version contains supplementary material available at 10.1007/s00467-022-05828-3.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outcomes and perception of cloud-based remote patient monitoring in children receiving automated peritoneal dialysis: a prospective study

Chan¹,

Liu²,

Or³

et al. 2022

Pediatr Nephrol

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“…Patients in the control group received the outpatient follow‐up management model, whereas patients in the observation group received the hospital‐community online management model under the background of prevention and control of COVID‐19. The inclusion and exclusion criteria [11] were shown as follows. The inclusion criteria consisted of patients (1) satisfying the diagnostic criteria of stage 5 chronic kidney disease by KDIGO (Kidney Disease: Improving Global Outcomes) [12]; (2) aged ≥60 years old; (3) receiving PD as kidney replacement therapy; (4) receiving PD for more than 3 months; (5) with complete clinical data; (6) with clear mind, normal thinking, relatively stable condition and able to communicate normally; and (7) who volunteered to participate in this study and signed informed consent forms.…”

Section: Methodsmentioning

confidence: 99%

“…Patients in the control group received the outpatient follow-up management model, whereas patients in the observation group received the hospital-community online management model under the background of prevention and control of COVID-19. The inclusion and exclusion criteria [11] were shown as follows. The inclusion criteria consisted of patients (1) satisfying the diagnostic criteria of stage 5 chronic kidney disease by KDIGO (Kidney Disease: Improving Global Outcomes) [12];…”

Section: Study Subjectsmentioning

confidence: 99%

Effect of hospital‐community online management on medication management of elderly patients with peritoneal dialysis during COVID‐19

Zhang,

Wang,

Xie

2023

Ther Apher Dial

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IntroductionThe study aimed to explore feasibility and effect of hospital‐community online management on the medication management of elderly peritoneal dialysis (PD) patients with end‐stage renal disease (ESRD) during COVID‐19.MethodsA total of 160 patients receiving PD were randomly divided into the control (n = 80, outpatient follow‐up management mode) and observation (n = 80, hospital‐community online management mode) groups. The self‐efficacy (General Self‐Efficacy Scale [GSES]), medication adherence (8‐item Morisky medication adherence scale [MMAS‐8]), quality of life (kidney disease quality of life short form [KDQOL‐SF]), and degree of depression (beck depression inventory [BDI]) before and after the intervention were compared.ResultsAfter the intervention, the scores of GSES (4.20 ± 0.46 vs. 3.09 ± 0.33), MMAS‐8 (5.82 ± 0.92 vs. 5.13 ± 1.25), and KDQOL‐SF were significantly higher, whereas the BDI score (9.50 ± 2.86 vs. 12.08 ± 2.95) was significantly lower in the observation group than in the control group (p < 0.05).ConclusionHospital‐community online management presents good effects in the medication management of PD patients with ESRD.

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“…According to previous reports, this RPM system provides better blood pressure control [ 8 , 13 ], increased patient survival, and decreased hospitalization rates and length of hospital stay [ 14 ], reduced the number of emergency visits and hospitalizations, especially in patients with higher comorbidity scores [ 15 ], and results in better patient satisfaction [ 16 ]. Recently, this RPM system was shown to improve patient-centered outcomes and reduced healthcare resource consumption in a randomized crossover-controlled trial [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Impact of Remote Monitoring Using the Sharesource Connectivity Platform on Adherence to Automated Peritoneal Dialysis in 51 Patients

et al. 2023

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The study was supported by a grant from Baxter Healthcare Corporation Conflict of interest:None declared Background:This study from a single center in Taiwan aimed to evaluate the impact of remote patient monitoring (RPM) using the Sharesource connectivity platform on adherence to automated peritoneal dialysis (APD) in 51 patients. Material/Methods:We analyzed data on 51 patients with end-stage renal disease (ESRD) under APD. They were treated with a traditional APD machine HomeChoice (phase 1), changed to new APD machine HomeChoice Claria for 12 weeks (phase 2), then connected to the Sharesource platform for another 12 weeks (phase 3), and were followed up for 1 year. The non-adherence rate was compared between the 3 phases. The secondary outcomes included peritonitis rate, hospitalization rate, and hospitalization days, 1 year before and after receiving a new APD machine. Patients were subdivided into good and poor adherence (>1 episode of non-adherence in phase 1) groups for further analysis. Results:The average non-adherence rates were 10.5%, 5.1%, and 4.9% in phases 1, 2, and 3, respectively, although differences were not significant. Serum potassium (P<0.0001) and C-reactive protein (CRP) (P=0.026) levels significantly decreased in phase 3. The 1-year peritonitis rate, hospitalization rate, and number of days of hospitalization showed no significant changes. Subgroup analysis revealed that the non-adherence rate in the poor adherence group decreased from 48.4% in phase 1 to 14.2% and 12.4% in phases 2 and 3, respectively (P=0.007). Conclusions:Remoting monitoring using the Sharesource connectivity platform increased dialysis adherence in APD treatment, especially in patients with poor adherence. Serum potassium level and inflammation status were also improved by this system.

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Effects of a remote patient monitoring system for patients on automated peritoneal dialysis: a randomized crossover controlled trial

Cited by 13 publications

References 36 publications

Outcomes and perception of cloud-based remote patient monitoring in children receiving automated peritoneal dialysis: a prospective study

Outcomes and perception of cloud-based remote patient monitoring in children receiving automated peritoneal dialysis: a prospective study

Effect of hospital‐community online management on medication management of elderly patients with peritoneal dialysis during COVID‐19

Evaluation of the Impact of Remote Monitoring Using the Sharesource Connectivity Platform on Adherence to Automated Peritoneal Dialysis in 51 Patients

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