Abstract: FR-PO684
Impact of Peritoneal Dialysis (PD) Remote Monitoring on PD Services
Session Information
- Dialysis: Peritoneal Dialysis - II
October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 703 Dialysis: Peritoneal Dialysis
Authors
- Hendra, Heidy, Southend University Hospital NHS Foundation Trust, Chelmsford, United Kingdom
- Pharro, Georgina J., Southend University Hospital NHS Foundation Trust, Chelmsford, United Kingdom
- Lewis, Sarah, Southend University Hospital NHS Foundation Trust, Chelmsford, United Kingdom
- Mccornack, Tina, Southend University Hospital NHS Foundation Trust, Chelmsford, United Kingdom
- Balasubramaniam, Gowrie, Southend University Hospital NHS Foundation Trust, Chelmsford, United Kingdom
Background
Remote monitoring to manage renal patients is increasing. HomeChoice Claria with Sharesource™ (Baxter Healthcare Ltd) is a web-based, two-way connectivity platform enabling remote monitoring of automated peritoneal dialysis (APD). We introduced it in 10/2015 and reviewed it’s impact after 12-months.
Methods
48 patients were studied; median age 62.8 years (24 – 90), 30 males. Patients and clinical information were identified from the electronic patient records system and medical records. We investigated the number of patient on PD, months on treatment, outpatient attendances, remote consultations, home visits and staff travel. We also looked at take-up/ drop-off rates. Continuous variables were analysed by the independent samples t-test.
Results
Average number of patients on active PD increased by 14%, patient months on treatment increased by 12% as patients spent 4 months longer on treatment on average. Outpatient attendances increased by 34%. 60 remote consultations were performed, averaging 0.2 remote consultations/ patient/ month. The number of home visits per month increased by 41% and the visits per patient increased by 29%. The mean nurse mileage/ month increased by 57% and mileage/ patient/ month increased by 43% in 2015/16 (Results shown in Table 1). There was a net loss of 9 patients 12 months prior to implementation and a net gain of 2 patients 12 months after implementation.
Conclusion
More service was delivered with the same number of nursing staff. There was a rise in PD-related OP attendances per patient, mean home visits/ month and mileage/patient in 2015/6; this may be due to increased visit for educational purposes during system exchange as data collected across the year showed a reduction. Further study involving longer period of observation is needed to validate the result.
Summary of results
| Pre ShareSource (01/10/14 – 30/09/15) | Post ShareSource (01/10/15 – 30/09/16) | p-value | |
| No. patients on active PD (mean) | 21.5 | 24.5 | 0.05 |
| Number of months on treatment (mean) | 32.8 | 36.8 | 0.001 |
| Outpatient attendances/ month (mean) | 61.6 | 82.3 | 0.08 |
| No. home visits/ month (mean) | 11.3 | 15.8 | 0.03 |
| No. visits/ patient (mean) | 0.5 | 0.7 | 0.12 |
| Mileage/ patient/ month (mean) | 6.4 | 9.2 | 0.07 |
| Nurse mileage/ month (mean) | 139 | 217.8 | 0.02 |
| PD related blood tests/ month (mean) | 36.8 | 36.1 | 0.89 |
| PD catheter removal | 9 | 6 | |
| Net take on drop on-off rate | -9 | +2 |