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Abstract: PO0967

Peritoneal Dialysis Supplemental Telephone Support Program to Reduce 90-Day Drop-Out

Session Information

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Todd, Lucy Barker, Baxter International Inc, Deerfield, Illinois, United States
  • Gellens, Mary, Baxter International Inc, Deerfield, Illinois, United States
  • Mooney, Ann, American Renal Associates, Beverly, Massachusetts, United States
  • Mancini, Ann, Baxter International Inc, Deerfield, Illinois, United States
Background

Improving PD technique success is critical to meet Advancing American Kidney Health Initiative’s (AAKHI) aggressive growth goal by 2025. Per results in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) 2017, the United States First 90-day (F90) dropout rate was 11.4% vs. 8.4% for all PDOPPS countries. Focused clinical intervention may lessen F90 dropout. The objective of this study is to evaluate the impact of a Peritoneal Dialysis Supplemental Support (PDSS) service to reduce F90 loss in Automated Peritoneal Dialysis (APD) patients utilizing remote monitoring. The PDSS service consists of telephone calls to patients and clinic nurses. PDSS provides pre-emptive technical support to patients and actionable clinical insights to clinicians.

Methods

A dialysis provider enrolled non-randomized, incident PD patients, who were being treated with a 2-way APD cycler enabled with a remote management system, into a PDSS program. The PDSS nurse reviews remote monitoring data and looks for trends in alerts and alarms that may lead to F90 dropout. For technical alerts and alarms, a member of the PDSS team proactively calls the patient to discuss technique and training reinforcement. For clinical alerts and alarms, the PDSS nurse contacts the clinic PD nurse (PDRN), who remains the only party in control of clinical care.

Results

The dialysis provider enrolled 202 incident patients from 23 clinics into the PDSS program. The dialysis provider’s historical F90 loss within these clinics was 15.9%, N=69 for 2018-2020. PDSS began in November 2019 and continued through December 2020. Data revealed a decrease in F90 loss to 8.4%, N=17, for patients enrolled in PDSS, a 46.9% reduction in F90 loss (p=0.0032).

Conclusion

A supplemental PD telephone support service enhances the benefits of two-way remote patient monitoring. The patient benefits from timely support. The nurse benefits from additional analysis of clinical trends in the data. This enables the nurse to implement appropriate clinical interventions as needed. The result is a statistically significant reduction in F90 loss rate.

Funding

  • Commercial Support