Home Hemodialysis and Remote Monitoring: Current Technology, Requirements and Capabilities

Schlaeper, Christian; Díaz-Buxó, José A.

doi:10.1159/000082006

Cited by 9 publications

(5 citation statements)

References 18 publications

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“…This could extend beyond support to intervention if needed. For example, the measures for dealing with hypotension could be triggered remotely by monitoring staff, or monitoring staff could call for an ambulance if they detect that something is wrong and do not get a response from the patient, as discussed by Schlaeper and Diaz-Buxo [ 9 ]. As well as remote monitoring, D1 highlighted the possibility of clinicians sending messages to the patient via the system and two patients proposed that the system should be able to automatically record and upload information required by clinicians for tracking their progress over time.…”

Section: Discussionmentioning

confidence: 99%

“…Although some studies of professionals’ attitudes [ 4 , 5 ] focus principally on patient outcomes, a US study [ 9 ] found that the main concern that nephrologists have when motivating patients to go on HHD was patient safety. An Australian study of patients and their carers [ 10 ] also found that patients value survival and convenience in choosing treatment, a finding echoed by Cafazzo et al [ 11 ] in their study of nocturnal HHD.…”

Section: Introductionmentioning

confidence: 99%

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Patients’ and carers’ experiences of interacting with home haemodialysis technology: implications for quality and safety

et al. 2014

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BackgroundLittle is known about patients’ and carers’ experiences of interacting with home haemodialysis (HHD) technology, in terms of user experience, how the design of the technology supports safety and fits with home use, and how the broader context of service provision impacts on patients’ use of the technology.MethodsData were gathered through ethnographic observations and interviews with 19 patients and their carers associated with four different hospitals in the UK, using five different HHD machines. All patients were managing their condition successfully on HHD. Data were analysed qualitatively, focusing on themes of how individuals used the machines and how they managed their own safety.ResultsFindings are organised by three themes: learning to use the technology, usability of the technology, and managing safety during dialysis. Home patients want to live their lives fully, and value the freedom and autonomy that HHD gives them; they adapt use of the technology to their lives and their home context. They also consider the machines to be safe; nevertheless, most participants reported feeling scared and having to learn through mistakes in the early months of dialysing at home. Home care nurses and technicians provide invaluable support. Although participants reported on strategies for anticipating problems and keeping safe, perceived limitations of the technology and of the broader system of care led some to trade off safety against immediate quality of life.ConclusionsEnhancing the quality and safety of the patient experience in HHD involves designing technology and the broader system of care to take account of how individuals manage their dialysis in the home. Possible design improvements to enhance the quality and safety of the patient experience include features to help patients manage their dialysis (e.g. providing timely reminders of next steps) and features to support communication between families and professionals (e.g. through remote monitoring).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patients’ and carers’ experiences of interacting with home haemodialysis technology: implications for quality and safety

et al. 2014

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“…Furthermore, telemedicine can eliminate distance barriers and can improve access to medical services [5]. Equipment and monitoring system dedicated to home hemodialysis have been recently introduced in response to the demand for more frequent therapies at home [6]. In a paper published by Cafazzo et al [7], the availability of RM leads to an increased interest in home hemodialysis and lowered patients’ perceived barriers, such as anxiety and lack of self-efficacy.…”

Section: Introductionmentioning

confidence: 99%

Remote Monitoring of Automated Peritoneal Dialysis Improves Personalization of Dialytic Prescription and Patient’s Independence

et al. 2018

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Background: Remote monitoring (RM) supports a healthcare model that enhances patients’ self-management. We evaluated the utility of RM in patients undergoing automated peritoneal dialysis (APD). Methods: We observed 37 RM-APD patients, 16 incidents, and 21 prevalents switched from traditional APD (T-APD). We observed the number of changes for APD prescription, the frequency of visits, and PD adequacy parameters during 1 year of RM utilization in APD. Results: The APD prescriptions were modified more frequently in RM-APD vs. T-APD in incident (p = 0.002) and prevalent patients (p = 0.045). Visits were significant less in RM-APD than in T-APD for incident patient (p = 0.008). No significant difference was found between prevalent populations. PD adequacy was similar in both groups. Conclusions: Our results demonstrate that RM allows an efficient use of healthcare resources, helping to improve personalization of APD prescription and to intervene early with “trouble shooting”, thereby reducing the frequency of in-person visits for emergency problems.

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“… 16 , 17 Concerns also exist regarding the complexity of home HD 18 and patient safety while performing unsupervised HD at home. 18 – 20 …”

Section: Introductionmentioning

confidence: 99%

Home hemodialysis: a comprehensive review of patient-centered and economic considerations

Walker¹,

Howard²,

Morton³

2017

CEOR

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Internationally, the number of patients requiring treatment for end-stage kidney disease (ESKD) continues to increase, placing substantial burden on health systems and patients. Home hemodialysis (HD) has fluctuated in its popularity, and the rates of home HD vary considerably between and within countries although there is evidence suggesting a number of clinical, survival, economic, and quality of life (QoL) advantages associated with this treatment. International guidelines encourage shared decision making between patients and clinicians for the type of dialysis, with an emphasis on a treatment that aligned to the patients’ lifestyle. This is a comprehensive literature review of patient-centered and economic impacts of home HD with the studies published between January 2000 and July 2016. Data from the primary studies representing both efficiency and equity of home HD were presented as a narrative synthesis under the following topics: advantages to patients, barriers to patients, economic factors influencing patients, cost-effectiveness of home HD, and inequities in home HD delivery. There were a number of advantages for patients on home HD including improved survival and QoL and flexibility and potential for employment, compared to hospital HD. Similarly, there were several barriers to patients preferring or maintaining home HD, and the strategies to overcome these barriers were frequently reported. Good evidence reported that indigenous, low-income, and other socially disadvantaged individuals had reduced access to home HD compared to other forms of dialysis and that this situation compounds already-poor health outcomes on renal replacement therapy. Government policies that minimize barriers to home HD include reimbursement for dialysis-related out-of-pocket costs and employment-retention interventions for home HD patients and their family members. This review argues that home HD is a cost-effective treatment, and increasing the proportion of patients on this form of dialysis compared to hospital HD will result in a more equitable distribution of good health outcomes for individuals with ESKD.

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Home Hemodialysis and Remote Monitoring: Current Technology, Requirements and Capabilities

Cited by 9 publications

References 18 publications

Patients’ and carers’ experiences of interacting with home haemodialysis technology: implications for quality and safety

Patients’ and carers’ experiences of interacting with home haemodialysis technology: implications for quality and safety

Remote Monitoring of Automated Peritoneal Dialysis Improves Personalization of Dialytic Prescription and Patient’s Independence

Home hemodialysis: a comprehensive review of patient-centered and economic considerations

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