Survey: Noise, setup time and mobility among key issues when using automated PD
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Key takeaways:
- Noise level and setup time were the most important issues for patients using automated peritoneal dialysis.
- The survey was sent to patients on peritoneal dialysis or other modalities, caregivers and nurses.
A survey among patients and home dialysis nurses indicated that noise levels and setup time were key issues when using automated peritoneal dialysis machines.
“Addressing [automated peritoneal dialysis] APD cycler technical and therapy-related issues to improve usability, comfort and convenience within the home may affect PD uptake and retention,” James A. Sloand, MD, FACP, FASN, of the division of kidney diseases and hypertension at George Washington University School of Medicine and Health Sciences, and colleagues wrote. “Attention and priority must be given to patient-centric APD cycler design directed at including features that improve quality of life for the device end user.”
The authors noted the slow uptake of PD and home dialysis around the world, writing, “Despite offering greater lifestyle benefits to patients with [end-stage kidney disease] ESKD, adoption of [PD] remains low globally, particularly among minorities and the socioeconomically disadvantaged. While [APD] affords a high potential for reducing the burden of [kidney replacement therapy] KRT, understanding patient preferences is critical to guiding development of new and improved APD devices to better accommodate use in their daily lives.
“ ... [T]here is a need for safe, affordable APD cycler systems that are less intimidating for patients considering home dialysis and easier for patients to learn, operate and accommodate to use in their daily lives,” the authors wrote.
To determine issues surrounding APD, patients on the therapy, caregivers, nurses who worked with patients on PD and patients not using the therapy (n = 118) were surveyed by the Link Group, a marketing research firm, to quantify APD feature preferences. Respondents were asked to rate eight specific cycler attributes, including portability, noise, setup time, device size, setup directions, battery power and consumables. PD nurses were asked separately about control of the therapy.
In the survey, “nurses and patients were prompted to choose which of the attributes they found most preferrable,” Sloand told Healio.
The survey was conducted to help evaluate the benefits of a new APD cycler under development by Simergent LLC. Sloand is the chief medical officer for the medical device company, and co-author Steve J. Lindo is its CEO. “The device was developed by the manufacturer to address historical user complaints, injuries and issues inherent to currently marketed APD cyclers,” the authors wrote.
Results from the survey showed that, for all groups, portability in the home, noise level and setup time were the most important features. “Patients on PD gave highest priority to these features compared with other study participants, plausibly as features enabling improved lifestyle,” the authors wrote. “A simulated ‘coat rack’ style cycler with extended battery power that was easy to move in the home, silent, required only 10-minute setup, and had a fully animated instruction screen was preferred by all groups,” they wrote.
Sloand said meeting patient preferences is key to getting more patients to choose home dialysis. “One of the things that was clearly evident was that patients wanted mobility of the device in the home,” Sloand said. “We also found that noise level was important to patients. It was a bigger deal than we had expected. It can keep patients up at night.”
The authors concluded, “The results from this study and others highlight the importance of key device features for patients. Attention must be given to studies such as ours, given the goal of improving quality of life for the device end user. A greater understanding and adoption of patient-centric design by the dialysis community will allow more efficient product development in an industry increasingly under the pressure of narrowing margins.”
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