Through the Storm: Automated Peritoneal Dialysis with Remote Patient Monitoring during COVID-19 Pandemic

Bunch, Alfonso; Ardila, Freddy; Castaño, Roberto; Quiñonez, Sylvia; Corzo, Leyder

doi:10.1159/000511407

Cited by 23 publications

(50 citation statements)

References 8 publications

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“…As the COVID‐19 pandemic persists, the fear of transmission remains a prominent factor limiting engagement of CKD patients with the health care system 18,19 . Patients with chronic illness such as CKD have continued to avoid clinic visits or haemodialysis sessions due to this fear 18,20–22 . As such, an increase in the demand for home therapies, including peritoneal dialysis and telehealth consultations was observed 22–24 …”

Section: Discussionmentioning

confidence: 99%

“…18,19 Patients with chronic illness such as CKD have continued to avoid clinic visits or haemodialysis sessions due to this fear. 18,[20][21][22] As such, an increase in the demand for home therapies, including peritoneal dialysis and telehealth consultations was observed. [22][23][24] For some patients, peritoneal dialysis was the preferred mode of dialysis because it allowed them to stay home and conduct telehealth appointments remotely, thus alleviating fears of transmission as compared with haemodialysis.…”

Section: Discussionmentioning

confidence: 99%

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The COVID‐19 pandemic and access to health care in people with chronic kidney disease: A systematic review and meta‐analysis

et al. 2022

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Aim: This systematic review aims to evaluate the effect of the COVID-19 pandemic on access to health care for patients with CKD.Methods: MEDLINE and EMBASE databases were searched up to July 2021 (PROSPERO CRD42021230831). Data relevant to access to health care before and during the COVID-19 pandemic were extracted, including outcomes related to access to general nephrology consultations, telehealth, dialysis services and kidney transplantations. Relative and absolute effects were pooled using a random effects model to account for between-study heterogeneity. Risk of bias was assessed using a modified Quality in Prognostic Studies tool. The certainty of the evidence was rated using the GRADE approach.Results: Twenty-three studies across five WHO regions were identified. Reductions in transplantation surgeries were observed during the COVID-19 pandemic compared with the pre-COVID-19 era (risk ratio = 2.15, 95%CI = 1.51-3.06, I 2 = 90%, p < .001). Additionally, six studies reported increased use of telehealth services compared with pre-COVID-19 times. Four studies found reduced access to in-person general nephrology services and six studies reported interruptions to dialysis services during the COVID-19 pandemic. Conclusion:Our findings suggest COVID-19 pandemic may have led to reductions in access to kidney transplantation, dialysis and in-person nephrology care. Meanwhile, whilst the use of telehealth has emerged as a promising alternate mode of health care delivery, its utility during the pandemic warrants further investigation. This study has highlighted major barriers to accessing care in a highly vulnerable chronic disease group.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The COVID‐19 pandemic and access to health care in people with chronic kidney disease: A systematic review and meta‐analysis

et al. 2022

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“…Remote management of APD (RM-APD) patients provides more flexible treatment based on the changing needs of patients and can be associated with improved adherence to treatment [ 10 ]. Sanabria et al reported that adherence to PD prescription with the use of RM-APD was more than 90%.…”

Section: Discussionmentioning

confidence: 99%

“…In an adult study conducted in Latin America during the COVID-19 pandemic, there was no significant decrease in the rates of peritonitis in patients using RM-APD, but a significant decrease in the proportion of patients with poorly controlled hypertension [ 10 ]. This may be partly due to increased self-care of the patients, but mainly due to the positive impact of RM-APD on patient-centered clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Claria sharesource system from the perspectives of patient/caregiver, physician, and nurse in children undergoing automated peritoneal dialysis

et al. 2022

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Background Automated peritoneal dialysis (APD) is increasingly preferred worldwide. By using a software application (Homechoice with Claria sharesource system (CSS)) with a mod-M added to the APD device, details of the home dialysis treatment become visible for PD nurses and physicians, allowing for close supervision. We aimed to evaluate the perceptions of patients/caregivers, PD nurses, and physicians about the advantages and disadvantages of CSS. Methods Three different web-based questionnaires for patients/caregivers, nurses, and physicians were sent to 15 pediatric nephrology centers with more than 1 year of experience with CSS. Results Respective questionnaires were answered by 30 patients/caregivers, 22 pediatric nephrologists, and 15 PD nurses. Most of the nurses and physicians (87% and 73%) reported that CSS improved patient monitoring. A total of 73% of nurses suggested that CCS is not well known by physicians, while half of them reported reviewing CSS data for all patients every morning. Sixty-eight percent of physicians thought that CSS helps save time for both patients/caregivers and healthcare providers by reducing visits. However, only 20% of patients/caregivers reported reduced hospital visits. A total of 90% of patients/caregivers reported that being under constant monitoring made them feel safe, and 83% stated that the patient’s sleep quality improved. Conclusions A remote monitoring APD system, CSS, can be successfully applied with children for increased adherence to dialysis prescription by giving shared responsibility and may help increase the patient’s quality of life. This platform is more commonly used by nurses than physicians. Its potential benefits should be evaluated in further well-designed clinical studies with larger patient groups. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information . Supplementary Information The online version contains a graphical abstract available at 10.1007/s00467-022-05563-9.

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“…However, there are limited data in the literature on the reliability and success of RPM programs during the COVID-19 era. One of the studies conducted with 1023 PD patients on the RPM program showed that patients’ treatment adherence was improved, the proportion of poorly controlled hypertension decreased and the peritonitis rate did not change significantly [ 12 ]. In another study, PD modalities were compared during the lockdown period [ 18 ].…”

Section: Coronavirus Disease 2019 Pandemicmentioning

confidence: 99%

The utility of remote patient management in peritoneal dialysis

Yeter

Manani

Ronco

2021

Clinical Kidney Journal

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Remote patient management (RPM) programs are one of the most crucial innovation in the peritoneal dialysis field, which has been developed in the last decade. RPM programs are associated with favorable clinical outcomes by increasing the adherence of the patients to peritoneal dialysis prescription. The literature supports that RPM is associated with increased blood pressure control and technique survival and decreased hospitalization rate, length of hospital stay, and health cost. The RPM program also facilitates patient follow-up in the COVID-19 pandemic, increases treatment adherence, and leads to better clinical outcomes. However, published data remains scarce and mainly consists of observational or retrospective studies with a relatively low number of patients. Therefore, randomized controlled trial results will be more informative to demonstrate the effect of RPM programs on clinical outcomes.

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Through the Storm: Automated Peritoneal Dialysis with Remote Patient Monitoring during COVID-19 Pandemic

Cited by 23 publications

References 8 publications

The COVID‐19 pandemic and access to health care in people with chronic kidney disease: A systematic review and meta‐analysis

The COVID‐19 pandemic and access to health care in people with chronic kidney disease: A systematic review and meta‐analysis

Evaluation of the Claria sharesource system from the perspectives of patient/caregiver, physician, and nurse in children undergoing automated peritoneal dialysis

The utility of remote patient management in peritoneal dialysis

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