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Kidney Week

Abstract: TH-PO315

Impact of the Implementation of Management Protocols Using Priority Signals in Automated PD Patients Using Remote Patient Monitoring

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Rojas-Diaz, Mario, SEDESA, Mexico, City, Mexico
  • Mercado, Victor Armando, Hospital Dr Belisario Dominguez SEDESA, Mexico, Mexico
  • Cisneros, Abril E., Hospital Dr Belisario Dominguez SEDESA, Mexico, Mexico
  • Ramos, Alfonso, Baxter Mexico, San Andres Ocotlan, Mexico
  • Hernandez-Ordonez, Sergio O., Baxter Mexico, San Andres Ocotlan, Mexico
Background

The recent introduction of a two-way Remote Patient Monitoring (RPM) for the management of Automated Peritoneal Dialysis (APD) patient has made it possible to assess patient’s adherence to the therapy, as well as dialysis treatment-related complications. This system was introduced in this hospital 2 years ago. The purpose of the study is to assess the impact on the adherence and lost treatment times after the implementation of protocols using the signals provided by the RPM system.

Methods

This is a retrospective study in a cohort of patients receiving APD. 183 patients in the APD program of the Hospital Belisario Dominguez under remote monitoring were included. On the basis of the messages provided by the system, a program was developed in order to prioritize patient care and interventions according to the type and number of flags shown; then, signals were categorized into treatment-related signals and system-related signals. Based on this, protocols of care and management strategies were established, and change in the number medium priority signals (MPS) and High priority signal (HPS), impact on lost treatment times and adherence to treatment were assessed.

Results

Signals from 203 patients provided by the system throughout one week were assessed and dedicated protocols were implemented afterwards. Patients were reassessed 6 months after the implementation of the protocols. Patients without MPS improve 20% (p<0.001) and patients with more than 6 MPS reduce 67% (0.0001). Patient without HPS signals improve 36% (p<0.0001) and patients with more than 6 HPS decrease 73% (p<0.0001) . Patients with not loss of treatment time increase 6% and patients with more than 300 minutes lost reduce 20% (p<0.004), adherence improve 29% (0.001)

Conclusion

Remote monitoring makes it possible to differentiate treatment-related complications and to establish specific processes of care, allowing for more effective treatment times and enhanced patient’s adherence to his/her treatment.