Variations in provider practices in remote patient monitoring on peritoneal dialysis in the USA and Canada

O El Shamy, Division of Renal Diseases and Hypertension, George Washington University, Washington, DC, USA.
R Fadel, Division of Nephrology & Hypertension, Vanderbilt University Medical Center, Nashville, TN, USA.
E D. Weinhandl, Department of Pharmaceutical Care and Health Systems, University of Minnesota, Minneapolis, Minnesota, USA.
G Abra, Division of Nephrology, Stanford University, Palo Alto, California, USA.
M Salani, Division of Nephrology & Hypertension, Vanderbilt University Medical Center, Nashville, TN, USA.
J I. Shen, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, USA.
J Perl, Division of Nephrology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
T S. Malavade, Division of Nephrology, University Health Network, University of Toronto, Toronto, Canada.
D Chatoth, Fresenius Medical Care, Waltham, MA, USA.
M V. Naljayan, DaVita Kidney Care, Denver, CO, USA.
K B. Meyer, Home Dialysis Workgroup, Dialysis Clinic Inc, Nashville, TN, USA.
S Q. Lew, Division of Renal Diseases and Hypertension, George Washington University, Washington, DC, USA.
M J. Oliver, Department of Medicine, Division of Nephrology, University of Toronto, Toronto, Ontario, Canada.
T A. Golper, Division of Nephrology & Hypertension, Vanderbilt University Medical Center, Nashville, TN, USA.
J Uribarri, Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
R R. Quinn, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

Document Type

Journal Article

Publication Date

8-6-2024

Journal

Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis

DOI

10.1177/08968608241270294

Keywords

Dialysis; patient monitoring; peritoneal dialysis; remote

Abstract

Automation has allowed clinicians to program PD treatment parameters, all while obtaining extensive individual treatment data. This data populates in a centralized online platform shortly after PD treatment completion. Individual treatment data available to providers includes patients' vital signs, alarms, bypasses, prescribed PD treatment, actual treatment length, individual cycle fill volumes, ultrafiltration volumes, as well as fill, dwell, and drain times. However, there is no guidance about how often or if this data should be assessed by the clinical team members. We set out to determine current practice patterns by surveying members of the home dialysis team managing PD patients across the United States and Canada. A total of 127 providers completed the survey. While 91% of respondents reported having access to a remote monitoring platform, only 31% reported having a standardized protocol for data monitoring. Rating their perceived importance of having a standard protocol for remote data monitoring, on a scale of 0 (not important at all) to 10 (extremely important), the average response was 8 (physicians 7; nurses 9). Most nurses reported reviewing the data multiple times per week, whereas most physicians reported viewing the data only during regular/monthly visits. Although most of the providers who responded have access to remote monitoring data and feel that regular review is important, the degree of its utilization is variable, and the way in which the information is used is not commonly protocolized. Working to standardize data interpretation, testing algorithms, and educating providers to help process and present the data are important next steps.

Department

Medicine

Link to Full Text

Share

COinS