Telemonitoring system for patients with chronic kidney disease undergoing peritoneal dialysis: Usability assessment based on a case study

Abstract

There are two million people with chronic kidney disease (CKD) worldwide. In Mexico, it is estimated that by 2025, there will be 212 thousand CKD cases. Among the renal replacement treatments, peritoneal dialysis (PD) exists either in the continuous ambulatory (CAPD) or automated (APD) mode, which requires continuous monitoring and strict control. Thus, several software systems have been proposed to perform reliable remote monitoring of patients using PD but also to achieve the goal with effectiveness, efficiency and satisfaction; i.e., in software engineering, this is called usability. However, few studies have addressed usability issues using case studies with patients and medical staff in real domains. In this paper, we present a usability assessment of a telemonitoring system for patients with CKD on peritoneal dialysis treatment through a case study with patients and medical staff of the Mexican Institute of Social Security (IMSS). The usability evaluation was carried out through the application of two satisfaction instruments. These instruments evaluated multiple usability criteria, such as navigability, interactivity, motivation, satisfaction, and applicability. The results obtained from the usability evaluation show that, on average, the services offered by the system have 91.3% acceptance by users (patient-doctors), with the APD and CAPD exchange data registration services having the highest acceptance for patients, with a positive perception of 94.5% and 92.3%, respectively. Meanwhile, for the doctors and nurses, the alarm reception for patients in a risk situation was highest with 95% acceptance. Based on the obtained results, the evaluated telemonitoring system holds wide acceptance, satisfaction, and applicability from patients’ and doctors’ perspectives. It is also noted that the evaluated system considers and satisfies the requirements and suitable parameters that should be monitored in PD treatment according to studies presented in the literature.

eHealth interventions to support patients in delivering and managing peritoneal dialysis at home: A systematic review

“…30 Of the other included studies, six were pre versus post designs 31 –36 and three had no comparison (observational studies with only follow-up measures). 37 –39 Further details on study characteristics are described in Tables 1 to 3.…”

“…The delivery method of the eHealth interventions was varied across studies. Seven of the included studies involved an intervention using an application on a tablet, device or a hand phone, 31,32,34,36 –39 and three used online communication sites. 25,26,33 Other methods included a computer-based platform 35 accessed through a website, video conference, 27 telephone calls 28 and a personal digital assistant device 29 (Tables 1 to 3).…”

“…Five studies reported on QoL 26,28,31,33,36 and nine studies reported on patient satisfaction. 25,26,28,31 –33,36 –38 One further study reported an economic evaluation. 34…”

Remote monitoring in peritoneal dialysis: benefits on clinical outcomes and on quality of life

“…Indeed, the KDQL-SF is an instrument developed for individuals with kidney disease and on dialysis, but there are not specific questions assessing the utility of home dialysis monitoring. For this reason, we designed an internal questionnaire, to better evaluate the usability of the telemonitoring system, similarly to Martinez Garcia et al [ 35 ] in their research article.…”

Telemedizin 2.0 bei Heimdialyse

“…Offenbar haben kommerzielle Anbieter auch schon "PD-Apps" bis zum Stadium eines Prototyps entwickelt, allerdings aufgrund von Regulationsschwierigkeiten und Kosten noch nicht angeboten. Im Rahmen von kleinen Feasibility-Studien wurde zumindest darauf hingewiesen, dass ein solcher Ansatz bei Ärzten und Patienten eine hohe Akzeptanz finden könnte [9]. Es bleibt zu hoffen, dass in Zukunft die Gruppe der chronisch nierenkranken Patienten allgemein sowie Dialysepatienten im Speziellen mehr in den Fokus von Industrie, Entwicklern und Kostenträgern rückt und dass bestehende App-Angebote für diese Patienten erweitert und weiterentwickelt werden [10].…”