Remote treatment monitoring for peritoneal dialysis lowers hospitalization, technique failure rates
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The frequent use of remote treatment monitoring for patients on peritoneal dialysis is associated with less hospital admissions, shorter hospitalization length and lower technique failure rates, according to a study.
“In a large population of PD patients who registered online for the PatientHub [remote treatment monitoring] RTM application, we found higher [remote treatment monitoring] use was associated with lower hospitalization and sustained technique failure rates,” Sheetal Chaudhuri, of Fresenius Medical Care at the Global Medical Office in Waltham and Maastricht University Medical Center in The Netherlands, and colleagues wrote.
A retrospective analysis was performed using data from 6,343 adult patients with PD treated between October 2016 and May 2019. Patients with PD used a remote treatment monitoring program called PatientHub. PatientHub documented the daily PD treatment data including treatment date, total ultrafiltration, dialysate type, bag size and number used, medications added and manual exchanges performed.
Results showed 64.5% of patients were non-users who did not enter treatment data, 10.6% were moderate users and entered one to 15 treatment records and 24.9% were frequent users who entered more than 15 treatment records during 30-day baseline after registration. After 12-month follow-up, frequent users entered an average of 10 treatments on PatientHub.
The incidence rate of hospital admission during 3 (22%), 6 (24%), 9 (23%) and 12 (26%) months was lower in frequent RTM users compared with non-users. Hospitalization length incidence rate was also lower in frequent users after 3 (38%), 6 (35%), 9 (34%) and 12 (32%) months compared with non-users.
Researchers performed a Cox analysis which showed the adjusted risk of sustained PD technique failure in frequent users was lower than that of non-users at 3 (33%), 6 (31%), 9 (31%) and 12 (27%) months. PD duration estimate with Kaplan-Meier estimated that frequent users of PatientHub remained on a PD modality longer than non-users.
“It appears prudent for PD care teams and providers to consider adopting RTM applications to better engage patients in their care, recognize and manage potential complications in a timely manner, improve the sustainability on the modality and improve patient outcomes,” the researchers wrote.
According to a press release, Fresenius Medical Care North America will its research as technology advances and more patients adhere to the PatientHub RTM platform.
“We are excited to see evidence that remote monitoring has an important role in improving patient outcomes and success with home treatment,” Dinesh Chatoth, MD, associate chief medical officer for Fresenius Medical Care North America in Waltham and co-author of the study, said in the press release. “This technology is helping our care teams to better engage and treat patients, as well as helping patients successfully stay on their PD modality longer.” – by Erin T. Welsh
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Disclosures: Chaudhuri reports being employed by Fresenius Medical Care. Chatoth reports being employed by Fresenius Medical Care North America. Please see the study for other authors’ relevant financial disclosures.
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