Abstract: FR-OR77
Outcomes of an Assisted Peritoneal Dialysis Program in the United States
Session Information
- Managing the Many Facets of Home Dialysis
November 03, 2023 | Location: Room 120, Pennsylvania Convention Center
Abstract Time: 05:24 PM - 05:33 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Hussein, Wael F., Stanford University School of Medicine, Stanford, California, United States
- Chen, Shijie, Satellite Healthcare, San Jose, California, United States
- Atwal, Jugjeet, Satellite Healthcare, San Jose, California, United States
- Zheng, Sijie, Kaiser Permanente, Oakland, California, United States
- Abra, Graham E., Stanford University School of Medicine, Stanford, California, United States
Background
Staff-assisted peritoneal dialysis (PD) can support patients to initiate or remain on PD following challenges to self-care. These programs are not currently supported by Medicare in the Unites States (US) despite the intentions put forward in the Advancing American Kidney Health initiative to increase home dialysis utilization.
Methods
Assistance was provided by trained non-nurse healthcare personnel to patients with short-term limitations to self-care who lacked adequate support by family or friends. Descriptive statistics are provided on indications, services, and outcomes.
Results
A total of 121 referrals were received. Mean patient age was 71 (SD 14) years, and 45% were female. Forty five percent of the referrals were before completion of PD training, while the remaining 55% were for prevalent patients. The main indications for referral were physical function limitations (57%), cognition (47%), and psychosocial reasons such as anxiety (46%). A total of 48 referrals were cancelled due to resolved needs or inability to continue PD.
A total of 604 visits (12% virtual) were provided for 73 patients, with a median of 5 (interquartile range [IQR]: 3 to 10) visits per patient over a median of 8 (IQR 2 to 21) days. Services provided included setting up and observing PD treatments (81%), exit site care (36%), checking the blood pressure (36%), and checking the weight of the patient (28%).
A total of 68 (93%) patients were discharged on PD, with no further need for staff assistance. Three patients died during the course of the program and two transferred to in-center hemodialysis. No peritonitis or exit site infections were reported. During post-discharge follow up, 74% and 62% of patients continued on PD at six and 12 months.
Conclusion
Staff-assisted PD programs in the US delivered by non-nursing staff are feasible and effective. With a brief period of assistance, patients were able to successfully initiate or continue PD, leading to positive outcomes.