Remote patient monitoring can improve home dialysis adherence, outcomes
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Utilizing remote patient monitoring can improve dialysis adherence and in turn, decrease hospitalizations and mortality, according to a speaker at the virtual Annual Dialysis Conference.
“Remote patient monitoring platforms are being used more, and some have come to play a role in addressing several [barriers] to ensure adherence and the safety of our patients doing home dialysis,” Vikram Aggarwal, MD, from Northwestern University and Feinberg School of Medicine, said at the meeting. “These platforms allow us to look at their adherence, whether they are doing it four times a week or if they are going three times. So, this gives a good idea to the physicians and the nurses, and they can circle back with the patient and try to be more proactive than reactive in the approaches.”
Remote patient management (RPM) makes the following data available to physicians in real time:
- blood pressure and weight;
- fluid removal/ultrafiltration;
- blood flow rate for patients on home hemodialysis;
- inflow and outflow for patients on peritoneal dialysis; and
- adherence to dialysis.
Aggarwal mentioned surveys done in Australia and New Zealand that reported patient and physician feedback on RPM. According to the survey, patients reported that RPM reduced the burden of dialysis and that they had a sense of safety because “someone is watching me.” Similarly, physicians reported that RPM allowed for better adoption of home therapies and gave them a new perspective of what home therapy is like for patients.
“It helps create better data-driven discussions,” Aggarwal said.
Challenges associated with RPM include lack of internet connectivity, having someone to monitor and manage the data and knowing what data are worth watching, Aggarwal said. Current staffing shortages could make it difficult to have someone monitoring data all the time.
Aggarwal noted that more randomized control trials to evaluate RPM are needed.
“In the future, RPM could help us think about incorporating predictive analytics for tracking an early management of complications, such as automated external corporeal circuit planning in home hemodialysis patients to avoid bleeding; automated fluid volume adjustments to avoid hypertension or hyperkalemia; or PD fluid sampling to prevent infectious complications.”
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Aggarwal V, Remote patient management – Compliance management. Presented at: Annual Dialysis Conference; March. 4-6, 2022 (virtual meeting).
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