Influence of an Automated Peritoneal Dialysis (APD) Cycler-embedded Remote Patient Management (RPM) Platform on Time Spent by Nurses on Perceived Higher-Value Interactive Tasks with Patients

2017 ◽  
Author(s):  
Catherine Firanek
Keyword(s):  
Peritoneal Dialysis ◽  
Patient Management ◽  
Automated Peritoneal Dialysis ◽  
Remote Patient

scholarly journals Clinical implications of the implementation of a new automated peritoneal dialysis remote patient management system with cloud-based

2018 ◽  
Vol 1 (3) ◽  
pp. 117-120
Author(s):  
Valérie Jotterand-Drepper
Keyword(s):  
Peritoneal Dialysis ◽  
Early Identification ◽  
Patient Management ◽  
Clinical Implications ◽  
Automated Peritoneal Dialysis ◽  
Potential Influence ◽  
Catheter Dysfunction ◽  
Rpm System ◽  
Physical Limitations ◽  
Remote Patient

In the last decades, remote patient management (RPM) has been of growing interest in medical fields. In this article we describe the clinical implications of the implementation of a newly available automated peritoneal dialysis (APD) RPM system with cloud-based connectivity. This system provides data sent from the cycler about the course of the peritoneal dialysis (PD) therapy, offering the medical team the opportunity to analyse them on an everyday basis and subsequently remotely alter PD prescription.The main advantages discussed here are sparing of long or difficult travels, especially for patients with social, geographical or physical limitations, early identification and management of occurring issues such as catheter dysfunction or non-adherence to prescribed PD therapy, a potential clue to an imminent peritonitis, and finally a more personalized APD prescription. Further impacts of the implementation of RPM in peritoneal dialysis on patients outcomes, health costs and its potential influence on a greater take-on rate of the technique have still to be evaluated

Remote Patient Management in Automated Peritoneal Dialysis: A Promising New Tool

2018 ◽  
Vol 38 (1) ◽  
pp. 76-78 ◽  
Author(s):  
Valérie Jotterand Drepper ◽  
Pierre-Yves Martin ◽  
Catherine Stoermann Chopard ◽  
James A. Sloand
Keyword(s):  
Peritoneal Dialysis ◽  
Patient Management ◽  
Healthcare Providers ◽  
Disease Patient ◽  
Automated Peritoneal Dialysis ◽  
Technique Survival ◽  
Rpm System ◽  
Remote Patient ◽  
End Stage ◽  
The Impact

Remote patient management (RPM) has the potential to help clinicians detect early issues, allowing intervention prior to development of more significant problems. A 23-year-old end-stage kidney disease patient required urgent start of renal replacement therapy. A newly available automated peritoneal dialysis (APD) RPM system with cloud-based connectivity was implemented in her care. Pre-defined RPM threshold parameters were set to identify clinically relevant issues. Red flag dashboard alerts heralded prolonged drain times leading to clinical evaluation with subsequent diagnosis of and surgical repositioning for catheter displacement, although it took several days for newly-RPM-exposed staff to recognize this issue. Post-PD catheter repositioning, drain times were again normal as indicated by disappearance of flag alerts and unremarkable cycle volume profiles. Identification of < 90% adherence to prescribed PD therapy was then documented with the RPM system, alerting the clinical staff to address this important issue given its association with significant negative clinical outcomes. Healthcare providers face a “learning curve” to effect optimal utilization of the RPM tool. Larger scale observational studies will determine the impact of RPM on APD technique survival and resource utilization.

scholarly journals Remote patient management of peritoneal dialysis during COVID-19 pandemic

2020 ◽  
Vol 40 (4) ◽  
pp. 363-367 ◽  
Author(s):  
Claudio Ronco ◽  
Sabrina Milan Manani ◽  
Anna Giuliani ◽  
Ilaria Tantillo ◽  
Thiago Reis ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Patient Management ◽  
Remote Patient

scholarly journals Through the Storm: Automated Peritoneal Dialysis with Remote Patient Monitoring during COVID-19 Pandemic

2020 ◽  
pp. 1-4
Author(s):  
Alfonso Bunch ◽  
Freddy Ardila ◽  
Ricardo Castaño ◽  
Sylvia Quiñonez ◽  
Leyder Corzo
Keyword(s):  
Peritoneal Dialysis ◽  
Patient Monitoring ◽  
Remote Patient Monitoring ◽  
Automated Peritoneal Dialysis ◽  
Remote Patient

scholarly journals Remote Patient Management in Peritoneal Dialysis: Impact on Clinician’s Practice and Behavior

2019 ◽  
pp. 44-53
Author(s):  
Carlo Crepaldi ◽  
Anna Giuliani ◽  
Sabrina Milan Manani ◽  
Nicola Marchionna ◽  
Paola Piasentin ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Patient Management ◽  
Remote Patient ◽  
And Behavior

Remote Patient Monitoring Program in Automated Peritoneal Dialysis: Impact on Hospitalizations

2019 ◽  
Vol 39 (5) ◽  
pp. 472-478 ◽  
Author(s):  
Mauricio Sanabria ◽  
Giancarlo Buitrago ◽  
Bengt Lindholm ◽  
Jasmin Vesga ◽  
Lars-Göran Nilsson ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Patient Monitoring ◽  
Negative Impact ◽  
Monitoring Program ◽  
Remote Patient Monitoring ◽  
Automated Peritoneal Dialysis ◽  
Remote Patient ◽  
Hospital Days

Background Automated peritoneal dialysis (APD) is a growing PD modality but as with other home dialysis methods, the lack of monitoring of patients’ adherence to prescriptions is a limitation with potential negative impact on clinical outcome parameters. Remote patient monitoring (RPM) allowing the clinical team to have access to dialysis data and adjust the treatment may overcome this limitation. The present study sought to determine clinical outcomes associated with RPM use in incident patients on APD therapy. Methods A retrospective cohort study included 360 patients with a mean age of 57 years (diabetes 42.5%) initiating APD between 1 October 2016 and 30 June 2017 in 28 Baxter Renal Care Services (BRCS) units in Colombia. An RPM program was used in 65 (18%) of the patients (APD-RPM cohort), and 295 (82%) were treated with APD without RPM. Hospitalizations and hospital days were recorded over 1 year. Propensity score matching 1:1, yielding 63 individuals in each group, was used to evaluate the association of RPM exposure with numbers of hospitalizations and hospital days. Results After propensity score matching, APD therapy with RPM ( n = 63) compared with APD-without RPM ( n = 63) was associated with significant reductions in hospitalization rate (0.36 fewer hospitalizations per patient-year; incidence rate ratio [IRR] of 0.61 [95% confidence interval (CI) 0.39 – 0.95]; p = 0.029) and hospitalization days (6.57 fewer days per patient-year; IRR 0.46 [95% CI 0.23 – 0.92]; p = 0.028). Conclusions The use of RPM in APD patients is associated with lower hospitalization rates and fewer hospitalization days; RPM could constitute a tool for improvement of APD therapy.

scholarly journals Remote Patient Management in Peritoneal Dialysis Improves Clinical Outcomes

2019 ◽  
pp. 124-132 ◽  
Author(s):  
Sabrina Milan Manani ◽  
Carlo Crepaldi ◽  
Anna Giuliani ◽  
Grazia Maria Virzì ◽  
Marta Proglio ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Clinical Outcomes ◽  
Patient Management ◽  
Remote Patient

scholarly journals P1223PATIENT REMOTE MONITORING IN AUTOMATED PERITONEAL DIALYSIS: 2017-2019 CLINICAL EXPERIENCE IN A SINGLE CENTER

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Gianpaolo Amici ◽  
Antonina Lo Cicero ◽  
Mery Zuccolo ◽  
Rosella Ferraro Mortellaro ◽  
Dino Romanini ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Remote Patient Monitoring ◽  
Automated Peritoneal Dialysis ◽  
Telemedicine System ◽  
Daily Monitoring ◽  
Hill Area ◽  
Remote Patient ◽  
The Impact

Abstract Background and Aims We conducted an observational study in a group of patients in automated peritoneal dialysis (APD) to evaluate the impact of the introduction and the long-term use of a telemedicine system for remote patient monitoring (RPM, Claria Sharesource Baxter). Method From April 1 2017 to December 31 2019 (33 months) we followed 42 APD patients with RPM, sex F 20 M 22, age 70±14 years, on PD treatment for median 10 (IQR 3-23) months, distance from the center 18±14 km in mountain and hill area. Have been studied 505 months of RPM overall, per patient median 9 (IQR 3-19) months, corresponding to 11685 APD sessions overall, per patient median 206 (IQR 52-457) sessions. Results Have been registered 1125 alarms (red flags) overall, per patient median 9 (IQR 1-45) alarms, rate 2.2 alarms patient-month (0.1 alarms per session). Analyzing the causes of the alarms: “dwell time lost” (&gt;45 min) 1006 (89%), “drain anticipation” (&gt;2 times) 22 (2%), “fill or dwell bypass” (&gt;3 times) 15 (1%), “various causes” (&gt;10 times) 86 (8%). “Various causes” alarm group sums mainly slow drain for set kinking and insufficient drain volume. We count 195 remote modifications of dialysis program overall, median per patient 3 (IQR 1-7), rate 0.02 patient month with a ratio 0.2 modifications per alarm. Looking to program modification, the alarm type specifically linked to modifications has been insufficient drain volume of the “various causes” group (36 events, 18% of all modifications). We found a positive correlation between the number of treatments and alarms (r=0.534, p&lt;0.001). In the observation period the overall hospitalization days were 403, rate 0.8 days patient month, ratio 0.02 hospitalization days per APD RPM session and ratio 0.4 hospitalization days per alarm. Conclusion The study shows that APD with RPM improves patients’ follow-up changing the organization of the center. In the long term the telemedicine system shows the advantages of a careful and daily monitoring. The rates of alarm, change of prescription and hospitalization resulted very low in our experience.

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