Abstract: PO2422
Point-of-Care Creatinine Self-Testing in Renal Transplant Patients: An Assessment of Accuracy, Precision, and Patient Experience
Session Information
- Clinical and Immunologic Predictors of Post-Transplant Outcomes
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Fernandes da Costa, Fabiana, Imperial College NHS TRUST, London, United Kingdom
- Willicombe, Michelle, Imperial College NHS TRUST, London, United Kingdom
- Bramham, Kate, Department of Women and Children’s Health, King's College London, London, London, United Kingdom
- Kelly, Clare B., Department of Women and Children’s Health, King's College London, London, London, United Kingdom
Background
During the Covid-19 pandemic it has become increasingly important to provide virtual care for patients with CKD. Point-of-Care testing of capillary creatinine (POC-Cr) is now available and has demonstrated validity, ease of use, improved efficiency and cost-efficiency. We aimed to determine patients’ desire to self-monitoring of POC-Cr and their characteristics.
Methods
Renal transplant patients were shown how to perform self-POC-Cr testing with a NovaBio StatSensor®Xpress device, then undertook a test independently and answered survey questions about their attitude to self-testing of POC-Cr.
Results
All patients (N=189; Median age 52 years (IQR 40,64) ; 44 (23%) English as a second language; 128 (68%) male; Median eGFR 49 mls/min/1.73m2 (IQR 34,64) successfully performed a POC-Cr test and 110/120 (91%) of patients who completed the survey reported they would like to self-monitor POC-Cr. Most patients wished to reduce their clinic attendance and the majority were willing to have telephone consultations. Characteristics of the cohort are described in Table 1.
Conclusion
All transplant patients successfully performed a POC-Cr test with written instructions and a demonstration. Most patients would like to self-monitor POC-Cr and reduce clinic attendance. Limitations include the single-centre design, number of participants and language barrier. Virtual care including patient self-monitoring using POC-Cr should be explored.
Characteristics of patients who would and would not like to self-monitor POC-Cr at home
| Characteristics | Would like to self-monitor POC-Cr at home N=110 | Would not like to perform testing at home N=10 |
| Male, n (%) | 76 (69%) | 5 (50%) |
| Age (Years Median (IQR)) | 54 (41, 64) | 55 (40, 61) |
| English as Second Language | 40 / 109 (37%) | 2 (20%) |
| Educational level n (%) Primary School Secondary School Higher education | 5 / 77 (6%) 25 / 77 (32%) 47 / 77 (61%) | 1 / 9 (11%) 3 / 9 (33%) 5 / 9 (56%) |
| First Year post transplant | 41 (37%) | 5 (50%) |
| Ethnicity White Black Asian Other | 40 (36%) 16 (14%) 38 (34%) 16 (14%) | 1 (10%) 1 (10%) 7 (70%)* 1 (10%) |
| eGFR (mls/min/1.73m2 Median (IQR)) | 50 (38, 63) | 50 (24, 72) |
| After single test in clinic felt able to perform at home | 104 /108 (96%) | 6 (60%)** |
| Able to check blood pressure at home | 99 /107 (93%) | 9 /9 (100%) |
| Access to an email address | 100 (91%) | 7 (70%) |
| Access to a smartphone or a computer | 105 (95%) | 7 (70%)# |
| Has Remote Access to Laboratory Results | 96 (87%) | 5 (50%)## |
| Would like to reduce attendance at clinic | 85 /106 (80%) | 7 (70%) |
| Would be willing to have telephone consultations | 104 (95%) | 7 (70%)$ |
| Would be willing to have video consultations | 82 (75%) | 5 (50%) |