Abstract: PO1300
Blood Pressure Telemonitoring in a Large US Peritoneal Dialysis Population
Session Information
- Peritoneal Dialysis - 2
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 703 Dialysis: Peritoneal Dialysis
Authors
- Schreiber, Martin J., DaVita Inc, Denver, Colorado, United States
- Gonzales, Mike, DaVita Inc, Denver, Colorado, United States
- Van hout, Bram, DaVita Inc, Denver, Colorado, United States
- Bowlby, Brooke, DaVita Inc, Denver, Colorado, United States
- Cassin, Michelle, DaVita Inc, Denver, Colorado, United States
- Holly-Kestel, Jodi, DaVita Inc, Denver, Colorado, United States
Background
Home remote monitoring (HRM) is a telehealth strategy that utilizes cellular technology to transmit patients’ biometric data collected at home to the electronic health record of their dialysis provider. In April 2017, a HRM program was launched nationwide for peritoneal dialysis (PD) patients at a US large dialysis organization (LDO). Here, we report longitudinal trends in blood pressure (BP) control among PD patients participating in the HRM program.
Methods
Data for this analysis were abstracted from LDO electronic medical records. Patients included were dialyzing with PD and participating in the HRM program from Apr 2017-Jan 2020. The following outcomes were tracked monthly for all patients: mean BP, mean arterial BP (MAPB), number of transmitted BP measurements, number of BP alerts, and number of antihypertensive (anti-HTN) medications prescribed. BP alert thresholds were determined on a patient-by-patient basis by the treating physician.
Results
We identified 21,081 eligible patients (average age 59 years old; 57% male) from which >3.5 million individual BP measurements were transmitted. On average, there were 170 readings transmitted per-patient over the monitoring period of 43 months; in total, 764,658 total BP alerts occurred (36 BP alerts/patient). Only 34% of patients achieved the target BP of <130/80 mm Hg. We observed 30%, 23%, and 47%, of patients were prescribed 0, 1-3, and >3 anti-HTN medications, respectively. The most common action responding to BP alerts included changes in medications and in prescribed ultrafiltration volume. However, a significant percentage of PD patients did not see an improvement in MABP [Figure].
Conclusion
HRM identified a significant percentage of PD patients with uncontrolled BP. HRM could be a useful component of clinical programs designed to improve BP control and cardiovascular outcomes.