Mauricio Sanabria1, Giancarlo Buitrago2, Bengt Lindholm3, Jasmin Vesga4, Lars-Göran Nilsson5, Dongyan Yang6, Alfonso Bunch7, Angela Rivera8. 1. Baxter Renal Care Services (BRCS), Latin America, Bogotá, Colombia mauricio_sanabria@baxter.com. 2. Clinical Research Institute, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia. 3. Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden. 4. Baxter Renal Care Services (BRCS), Colombia, Bogotá, Colombia. 5. Baxter Healthcare, Renal Care Medical Affairs, Lund, Sweden. 6. Baxter Healthcare Corporation, Deerfield, Il, USA. 7. Baxter Renal Care Services (BRCS), Latin America, Bogotá, Colombia. 8. Baxter Renal Care Services (BRCS), Global, Deerfield, Il, USA.
Abstract
Background:Automated peritoneal dialysis (APD) is a growing PD modality but as with other home dialysis methods, the lack of monitoring of patients' adherence to prescriptions is a limitation with potential negative impact on clinical outcome parameters. Remote patient monitoring (RPM) allowing the clinical team to have access to dialysis data and adjust the treatment may overcome this limitation. The present study sought to determine clinical outcomes associated with RPM use in incident patients on APD therapy. Methods: A retrospective cohort study included 360 patients with a mean age of 57 years (diabetes 42.5%) initiating APD between 1 October 2016 and 30 June 2017 in 28 Baxter Renal Care Services (BRCS) units in Colombia. An RPM program was used in 65 (18%) of the patients (APD-RPM cohort), and 295 (82%) were treated with APD without RPM. Hospitalizations and hospital days were recorded over 1 year. Propensity score matching 1:1, yielding 63 individuals in each group, was used to evaluate the association of RPM exposure with numbers of hospitalizations and hospital days. Results: After propensity score matching, APD therapy with RPM (n = 63) compared with APD-without RPM (n = 63) was associated with significant reductions in hospitalization rate (0.36 fewer hospitalizations per patient-year; incidence rate ratio [IRR] of 0.61 [95% confidence interval (CI) 0.39 - 0.95]; p = 0.029) and hospitalization days (6.57 fewer days per patient-year; IRR 0.46 [95% CI 0.23 - 0.92]; p = 0.028).Conclusions:The use of RPM in APD patients is associated with lower hospitalization rates and fewer hospitalization days; RPM could constitute a tool for improvement of APD therapy.
Background:Automated peritoneal dialysis (APD) is a growing PD modality but as with other home dialysis methods, the lack of monitoring of patients' adherence to prescriptions is a limitation with potential negative impact on clinical outcome parameters. Remote patient monitoring (RPM) allowing the clinical team to have access to dialysis data and adjust the treatment may overcome this limitation. The present study sought to determine clinical outcomes associated with RPM use in incident patients on APD therapy. Methods: A retrospective cohort study included 360 patients with a mean age of 57 years (diabetes 42.5%) initiating APD between 1 October 2016 and 30 June 2017 in 28 Baxter Renal Care Services (BRCS) units in Colombia. An RPM program was used in 65 (18%) of the patients (APD-RPM cohort), and 295 (82%) were treated with APD without RPM. Hospitalizations and hospital days were recorded over 1 year. Propensity score matching 1:1, yielding 63 individuals in each group, was used to evaluate the association of RPM exposure with numbers of hospitalizations and hospital days. Results: After propensity score matching, APD therapy with RPM (n = 63) compared with APD-without RPM (n = 63) was associated with significant reductions in hospitalization rate (0.36 fewer hospitalizations per patient-year; incidence rate ratio [IRR] of 0.61 [95% confidence interval (CI) 0.39 - 0.95]; p = 0.029) and hospitalization days (6.57 fewer days per patient-year; IRR 0.46 [95% CI 0.23 - 0.92]; p = 0.028).Conclusions:The use of RPM in APD patients is associated with lower hospitalization rates and fewer hospitalization days; RPM could constitute a tool for improvement of APD therapy.
Authors: Sheetal Chaudhuri; Hao Han; Carlos Muchiutti; Jessica Ryter; Marta Reviriego-Mendoza; Dugan Maddux; John W Larkin; Len A Usvyat; Dinesh Chatoth; Jeroen P Kooman; Franklin W Maddux Journal: Kidney360 Date: 2020-02-17
Authors: Hasan H Yeter; Ebru Gok Oguz; Omer F Akcay; Refika Karaer; Emre Yasar; Murat Duranay; Mehmet D Ayli; Galip Guz Journal: Semin Dial Date: 2020-11-19 Impact factor: 2.886