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Background Non-adherence to the PD prescription is associated with technique failure, peritonitis, hospitalizations and mortality1-3. Historically, clinicians have been unable to accurately identify patients missing or shortening prescribed PD treatments, precluding intervention. APD cyclers embedded with Remote Patient Management (RPM) technology have the potential to detect early issues, allowing intervention to potentially prevent clinically significant events. Objective APD cyclers embedded with 2-way RPM technology (Amia or Claria with Sharesource) were used to evaluate actual vs prescribed time patients spent performing their dialysis. Methods Data from 252 APD patients (pts) with >3 months on APD cyclers with 2-way RPM capabilities were examined for weekly treatment frequency and actual vs prescribed treatment time. Results During the 1st month of therapy, 17.9% (45) of pts missed > four treatments (>10% of prescribed therapy) (Fig 1); 7.9% (20) of pts missed.> 9 treatments. In the 1st week of therapy, 23.8.2% (60) and 18.3% (21) of pts had >100 minutes (min) and >300 min, respectively, less actual therapy time than that prescribed (Fig 2). Similar results occurred over subsequent weeks.   Fig 1 Fig 2 Conclusion APD with RPM capability provides clinicians the visibility to identify home dialysis patients performing less than their prescribed therapy. Identification and awareness of receipt of less than prescribed dialysis therapy could reduce non-adherence and improve patient outcomes.. 1Bernardini J, Piraino B. Am J Kidney Dis 1998;31:101-107 2Bernardini J, Nagy M, Piraino B. Am J Kidney Dis 2000; 35:1104-1110 3Griva K, Yuanhong A, Asyraf et al. PloS One 2014;(9):e89001 |
Renal Division
Baxter Healthcare Corporation
作者： James Sloand
单位： Baxter Healthcare Corporation
作者： 蓝辉耀
单位： 香港中文大学医学院
作者： 田菁
单位： 复旦大学附属华山医院
作者： 杨琼琼
单位： 中山大学附属第一医院
作者： 刘必成
单位： 东南大学附属中大医院
作者： 许莹
单位： 北京大学第一医院
作者： 黄晓敏
单位： 上海交通大学医学院附属瑞金医院
作者： 林建雄
单位： 中山大学附属第一医院
作者： Jian SI MU WEI
单位： Japan
作者： 史伟
单位： 广东省人民医院
作者： Adrian Liew
单位： Singapore
作者： 张景红
单位： 解放军第八十五医院
作者： 刘学军
单位： 中日友好医院
作者： 董捷
单位： 北京大学第一医院
作者： 李文歌
单位： 中日友好医院
作者： 苏默
单位： 中日友好医院
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