Outcomes of Remote Patient Monitoring for Automated Peritoneal Dialysis: A Randomized Controlled Trial

Nephron ◽  
2021 ◽  
pp. 1-9
Author(s):  
Hee-Yeon Jung ◽  
Yena Jeon ◽  
Yon Su Kim ◽  
Dong Ki Kim ◽  
Jung Pyo Lee ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Peritoneal Dialysis ◽  
Kidney Disease ◽  
Patient Monitoring ◽  
Controlled Trial ◽  
Staff Satisfaction ◽  
Remote Patient Monitoring ◽  
Automated Peritoneal Dialysis ◽  
Randomized Controlled ◽  
Remote Patient

<b><i>Introduction:</i></b> We hypothesize that remote patient monitoring (RPM) for automated peritoneal dialysis (APD) and feedback could enhance patient self-management and improve outcomes. The aim of this study was to evaluate the efficacy of RPM-APD compared to traditional APD (T-APD) without RPM. <b><i>Methods:</i></b> In this multicenter, randomized controlled trial, patients on APD were randomized to T-APD (<i>n</i> = 29) or RPM-APD (<i>n</i> = 28) at 12 weeks and followed until 25 weeks. Health-related quality of life (HRQOL), patient and medical staff satisfaction with RPM-APD, and dialysis-related outcomes were compared between the 2 groups. <b><i>Results:</i></b> We found no significant differences in HRQOL scores at the time of enrollment and randomization between RPM-APD and T-APD. At the end of the study, the RPM-APD group showed better HRQOL for the sleep domain (<i>p</i> = 0.049) than the T-APD group and the T-APD group showed better HRQOL for the sexual function domain (<i>p</i> = 0.030) than the RPM-APD group. However, we found no significant interactions between the time and groups in terms of HRQOL. Different HRQOL domains significantly improved over time in patients undergoing RPM-APD (effects of kidney disease, <i>p</i> = 0.025) and T-APD (burden of kidney disease, <i>p</i> = 0.029; physical component summary, <i>p</i> = 0.048). Though medical staff satisfaction with RPM-APD was neutral, most patients were quite satisfied with RPM-APD (median score 82; possible total score 105 on 21 5-item scales) and the rating scores were maintained during the study period. We found no significant differences in dialysis adherence, accuracy, adequacy, overhydration status, blood pressure, or the number of unplanned visits between the 2 groups. <b><i>Discussion/Conclusion:</i></b> Although HRQOL and dialysis-related outcomes were comparable between RPM-APD and T-APD, RPM-APD was positive in terms of patient satisfaction. Further long-term and large-scale studies will be required to determine the efficacy of RPM-APD. <b><i>Trial Registration:</i></b> CRIS identifier: KCT0003390, registered on December 14, 2018 – retrospectively registered, https://cris.nih.go.kr/cris/search/search_result_st01.jsp?seq=12348.

scholarly journals Tele-transitions of Care (TTOC). A 12-month, Randomized Controlled Trial evaluating the use of Telehealth to achieve Triple Aim Objectives

2019 ◽  
Author(s):  
Kimberly Noel ◽  
Catherine Messina ◽  
Wei Hou ◽  
Elinor Schoenfeld ◽  
Gerald Kelly
Keyword(s):  
Randomized Controlled Trial ◽  
Patient Engagement ◽  
Patient Monitoring ◽  
Controlled Trial ◽  
Transitions Of Care ◽  
Control Group ◽  
Remote Patient Monitoring ◽  
Randomized Controlled ◽  
Healthcare Needs ◽  
Remote Patient

Abstract Background: Poor transitions of care leads to increased health costs, utilization and poor outcomes. This study evaluated Telehealth feasibility in improving transitions of care. Methods: This is a 12-month randomized controlled trial, evaluating the use of telehealth (remote patient monitoring and video visits) versus standard transitions of care with the outcomes of over utilization, access to care, medication management and adherence and patient engagement. Results: The study conducted between June 2017 and 2018, included 105 patients. Compared with the standard of care, Telehealth patients were more likely to have medicine reconciliation (p = 0.013) and were 7 times more likely to adhere to medication than the control group (p = 0.03). Telehealth patients exhibited enthusiasm (p = 0.0001), and confidence that Telehealth could improve their healthcare (p= 0.0001). Telehealth showed no statistical significance on ED utilization (p = 0.691) nor for readmissions (p = 0.31). 100% of Telehealth patients found the intervention to be valuable, 98% if given the opportunity, reported they would continue using telehealth to manage their healthcare needs, and 94% reported that the remote patient monitoring technology was useful. Conclusions: Telehealth can improve transitions of care after hospital discharge improving patient engagement and adherence to medications. Although this study was unable to show the effect of Telehealth on reduced healthcare utilization, more research needs to be done in order to understand the true impact of Telehealth on preventing avoidable hospital readmission and ED visits.

scholarly journals Tele-transitions of Care (TTOC). A 12-month, Randomized Controlled Trial evaluating the use of Telehealth to achieve Triple Aim Objectives.

2020 ◽  
Author(s):  
Kimberly Noel ◽  
Catherine Messina ◽  
Wei Hou ◽  
Elinor Schoenfeld ◽  
Gerald Kelly
Keyword(s):  
Emergency Department ◽  
Randomized Controlled Trial ◽  
Hospital Readmission ◽  
Patient Monitoring ◽  
Controlled Trial ◽  
Transitions Of Care ◽  
Emergency Department Utilization ◽  
Remote Patient Monitoring ◽  
Randomized Controlled ◽  
Remote Patient

Abstract Background: Poor transitions of care leads to increased health costs, over-utilization of emergency room departments, increased re-hospitalizations and causes poor patient experiences and outcomes. This study evaluated Telehealth feasibility in improving transitions of care.Methods: This is a 12-month randomized controlled trial, evaluating the use of telehealth (remote patient monitoring and video visits) versus standard transitions of care with the primary outcomes of hospital readmission and emergency department utilization and secondary outcomes of access to care, medication management and adherence and patient engagement. Electronic Medical Record data, Health Information Exchange data and phone survey data was collected. Multi-variable logistic regression models were created to evaluate the effect of Telehealth on hospital readmission, emergency department utilization, medication adherence. Chi-square tests or Fisher’s exact tests were used to compare the percentages of categorical variables between the Telehealth and control groups. T tests or Wilcoxon rank sum tests were used to compared means and medians between the two randomized groups.Results: The study conducted between June 2017 and 2018, included 102 patients. Compared with the standard of care, Telehealth patients were more likely to have medicine reconciliation (p = 0.013) and were 7 times more likely to adhere to medication than the control group (p = 0.03). Telehealth patients exhibited enthusiasm (p = 0.0001), and confidence that Telehealth could improve their healthcare (p= 0.0001). Telehealth showed no statistical significance on emergency department utilization (p = 0.691) nor for readmissions (p = 0.31). 100% of Telehealth patients found the intervention to be valuable, 98% if given the opportunity, reported they would continue using telehealth to manage their healthcare needs, and 94% reported that the remote patient monitoring technology was useful.Conclusions: Telehealth can improve transitions of care after hospital discharge improving patient engagement and adherence to medications. Although this study was unable to show the effect of Telehealth on reduced healthcare utilization, more research needs to be done in order to understand the true impact of Telehealth on preventing avoidable hospital readmission and emergency department visits.

scholarly journals Tele-transitions of Care (TTOC). A 12-month, Randomized Controlled Trial evaluating the use of Telehealth to achieve Triple Aim Objectives

2020 ◽  
Author(s):  
Kimberly Noel ◽  
Catherine Messina ◽  
Wei Hou ◽  
Elinor Schoenfeld ◽  
Gerald Kelly
Keyword(s):  
Emergency Department ◽  
Randomized Controlled Trial ◽  
Hospital Readmission ◽  
Patient Monitoring ◽  
Controlled Trial ◽  
Transitions Of Care ◽  
Emergency Department Utilization ◽  
Remote Patient Monitoring ◽  
Randomized Controlled ◽  
Remote Patient

Abstract Background : Poor transitions of care leads to increased health costs, over-utilization of emergency room departments, increased re-hospitalizations and causes poor patient experiences and outcomes. This study evaluated Telehealth feasibility in improving transitions of care. Methods : This is a 12-month randomized controlled trial, evaluating the use of telehealth (remote patient monitoring and video visits) versus standard transitions of care with the primary outcomes of hospital readmission and emergency department utilization and secondary outcomes of access to care, medication management and adherence and patient engagement. Electronic Medical Record data, Health Information Exchange data and phone survey data was collected. Multi-variable logistic regression models were created to evaluate the effect of Telehealth on hospital readmission, emergency department utilization, medication adherence. Chi-square tests or Fisher’s exact tests were used to compare the percentages of categorical variables between the Telehealth and control groups. T tests or Wilcoxon rank sum tests were used to compared means and medians between the two randomized groups. Results : The study conducted between June 2017 and 2018, included 102 patients. Compared with the standard of care, Telehealth patients were more likely to have medicine reconciliation (p = 0.013) and were 7 times more likely to adhere to medication than the control group (p = 0.03). Telehealth patients exhibited enthusiasm (p = 0.0001), and confidence that Telehealth could improve their healthcare (p= 0.0001). Telehealth showed no statistical significance on emergency department utilization (p = 0.691) nor for readmissions (p = 0.31). 100% of Telehealth patients found the intervention to be valuable, 98% if given the opportunity, reported they would continue using telehealth to manage their healthcare needs, and 94% reported that the remote patient monitoring technology was useful. Conclusions: Telehealth can improve transitions of care after hospital discharge improving patient engagement and adherence to medications. Although this study was unable to show the effect of Telehealth on reduced healthcare utilization, more research needs to be done in order to understand the true impact of Telehealth on preventing avoidable hospital readmission and emergency department visits.

scholarly journals Tele-transitions of Care (TTOC). A 12-month, Randomized Controlled Trial evaluating the use of Telehealth to achieve Triple Aim Objectives

2020 ◽  
Author(s):  
Kimberly Noel ◽  
Catherine Messina ◽  
Wei Hou ◽  
Elinor Schoenfeld ◽  
Gerald Kelly
Keyword(s):  
Emergency Department ◽  
Randomized Controlled Trial ◽  
Hospital Readmission ◽  
Patient Monitoring ◽  
Controlled Trial ◽  
Transitions Of Care ◽  
Emergency Department Utilization ◽  
Remote Patient Monitoring ◽  
Randomized Controlled ◽  
Remote Patient

Abstract Background : Poor transitions of care leads to increased health costs, over-utilization of emergency room departments, increased re-hospitalizations and causes poor patient experiences and outcomes. This study evaluated Telehealth feasibility in improving transitions of care. Methods : This is a 12-month randomized controlled trial, evaluating the use of telehealth (remote patient monitoring and video visits) versus standard transitions of care with the primary outcomes of hospital readmission and emergency department utilization and secondary outcomes of access to care, medication management and adherence and patient engagement. Electronic Medical Record data, Health Information Exchange data and phone survey data was collected. Multi-variable logistic regression models were created to evaluate the effect of Telehealth on hospital readmission, emergency department utilization, medication adherence. Chi-square tests or Fisher’s exact tests were used to compare the percentages of categorical variables between the Telehealth and control groups. T tests or Wilcoxon rank sum tests were used to compared means and medians between the two randomized groups. Results : The study conducted between June 2017 and 2018, included 102 patients. Compared with the standard of care, Telehealth patients were more likely to have medicine reconciliation (p = 0.013) and were 7 times more likely to adhere to medication than the control group (p = 0.03). Telehealth patients exhibited enthusiasm (p = 0.0001), and confidence that Telehealth could improve their healthcare (p= 0.0001). Telehealth showed no statistical significance on emergency department utilization (p = 0.691) nor for readmissions (p = 0.31). 100% of Telehealth patients found the intervention to be valuable, 98% if given the opportunity, reported they would continue using telehealth to manage their healthcare needs, and 94% reported that the remote patient monitoring technology was useful. Conclusions: Telehealth can improve transitions of care after hospital discharge improving patient engagement and adherence to medications. Although this study was unable to show the effect of Telehealth on reduced healthcare utilization, more research needs to be done in order to understand the true impact of Telehealth on preventing avoidable hospital readmission and emergency department visits.

scholarly journals Tele-transitions of Care (TTOC). A 12-month, Randomized Controlled Trial evaluating the use of Telehealth to achieve Triple Aim Objectives

2019 ◽  
Author(s):  
Kimberly Noel ◽  
Catherine Messina ◽  
Wei Hou ◽  
Elinor Schoenfeld ◽  
Gerald Kelly
Keyword(s):  
Randomized Controlled Trial ◽  
Patient Engagement ◽  
Patient Monitoring ◽  
Controlled Trial ◽  
Transitions Of Care ◽  
Control Group ◽  
Remote Patient Monitoring ◽  
Randomized Controlled ◽  
Healthcare Needs ◽  
Remote Patient

Abstract Background: Poor transitions of care leads to increased health costs, utilization and poor outcomes. This study evaluated Telehealth feasibility in improving transitions of care. Methods: This is a 12-month randomized controlled trial, evaluating the use of telehealth (remote patient monitoring and video visits) versus standard transitions of care with the outcomes of over utilization, access to care, medication management and adherence and patient engagement. Results: The study conducted between June 2017 and 2018, included 105 patients. Compared with the standard of care, Telehealth patients were more likely to have medicine reconciliation (p = 0.013) and were 7 times more likely to adhere to medication than the control group (p = 0.03). Telehealth patients exhibited enthusiasm (p = 0.0001), and confidence that Telehealth could improve their healthcare (p= 0.0001). Telehealth showed no statistical significance on ED utilization (p = 0.691) nor for readmissions (p = 0.31). 100% of Telehealth patients found the intervention to be valuable, 98% if given the opportunity, reported they would continue using telehealth to manage their healthcare needs, and 94% reported that the remote patient monitoring technology was useful. Conclusions: Telehealth can improve transitions of care after hospital discharge improving patient engagement and adherence to medications. Although this study was unable to show the effect of Telehealth on reduced healthcare utilization, more research needs to be done in order to understand the true impact of Telehealth on preventing avoidable hospital readmission and ED visits.

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

2020 ◽  
pp. 1-4
Author(s):  
Alfonso Bunch ◽  
Freddy Ardila ◽  
Ricardo Castaño ◽  
Sylvia Quiñonez ◽  
Leyder Corzo
Keyword(s):  
Peritoneal Dialysis ◽  
Patient Monitoring ◽  
Remote Patient Monitoring ◽  
Automated Peritoneal Dialysis ◽  
Remote Patient

Remote Patient Monitoring Program in Automated Peritoneal Dialysis: Impact on Hospitalizations

2019 ◽  
Vol 39 (5) ◽  
pp. 472-478 ◽  
Author(s):  
Mauricio Sanabria ◽  
Giancarlo Buitrago ◽  
Bengt Lindholm ◽  
Jasmin Vesga ◽  
Lars-Göran Nilsson ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Patient Monitoring ◽  
Negative Impact ◽  
Monitoring Program ◽  
Remote Patient Monitoring ◽  
Automated Peritoneal Dialysis ◽  
Remote Patient ◽  
Hospital Days

Background Automated peritoneal dialysis (APD) is a growing PD modality but as with other home dialysis methods, the lack of monitoring of patients’ adherence to prescriptions is a limitation with potential negative impact on clinical outcome parameters. Remote patient monitoring (RPM) allowing the clinical team to have access to dialysis data and adjust the treatment may overcome this limitation. The present study sought to determine clinical outcomes associated with RPM use in incident patients on APD therapy. Methods A retrospective cohort study included 360 patients with a mean age of 57 years (diabetes 42.5%) initiating APD between 1 October 2016 and 30 June 2017 in 28 Baxter Renal Care Services (BRCS) units in Colombia. An RPM program was used in 65 (18%) of the patients (APD-RPM cohort), and 295 (82%) were treated with APD without RPM. Hospitalizations and hospital days were recorded over 1 year. Propensity score matching 1:1, yielding 63 individuals in each group, was used to evaluate the association of RPM exposure with numbers of hospitalizations and hospital days. Results After propensity score matching, APD therapy with RPM ( n = 63) compared with APD-without RPM ( n = 63) was associated with significant reductions in hospitalization rate (0.36 fewer hospitalizations per patient-year; incidence rate ratio [IRR] of 0.61 [95% confidence interval (CI) 0.39 – 0.95]; p = 0.029) and hospitalization days (6.57 fewer days per patient-year; IRR 0.46 [95% CI 0.23 – 0.92]; p = 0.028). Conclusions The use of RPM in APD patients is associated with lower hospitalization rates and fewer hospitalization days; RPM could constitute a tool for improvement of APD therapy.

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