INTRODUCTION: Remote Patient Monitoring (RPM) is a strategy that allows for accurate home monitoring of chronic patients enabling the team to improve care through prevention and early identification of problems. Peritoneal dialysis (PD) is a home-based therapy representing an ideal model for testing the ability of RPM to improve clinical outcomes by allowing the 2-way link between health providers and patients. The literature confirms that RPM applied to automated PD (APD) allows an efficient use of healthcare resources, helping to improve tailoring of APD prescription and to intervene early with troubleshooting, promptly identifying patients with higher risk of complications and reducing the frequency of in-person visits for emergency problems. The aim of the this study was to investigate the benefits of prolonged use of RPM-APD. In particular, we compared outcomes in patients with and without exposure of RPM.
METHODS: This was an observational study, comparing long-term outcomes in patients with (current patients) and without (historical data) exposure of RPM. We evaluated: patient’s drop-out and technique failure, the number of scheduled and unscheduled hospital visits, the number of episodes of overhydration, rate of hospitalization, episodes of non-compliance to prescription, patient and hospital team time spent in travelling and management of therapy, healthcare costs and patient’s expenditure, miles travelled by patients from home to hospital and viceversa.
RESULTS: In our experience matured over 2 years in a cohort of prevalent patients we could observe a significant reduction in all outcomes analyzed (Figure 1). In particular, the patient’s drop-out and technique failure, the number of scheduled and unscheduled hospital visits, the number of episodes of overhydration, the rate of hospitalization, the number of episodes of non-compliance to prescription were lower in RPM-APD. The distance travelled by patients in case of RM-APD was with a time saving for patients. The management of therapy, healthcare costs and patient’s expenditure were reduced in RPM-APD.
CONCLUSIONS: In conclusion, giving to the patients and their caregivers the possibility to solve some issues remaining in their home environment, RPM offers a benefit in terms of quality of life. All these data contribute to improving clinical outcomes and technique survival with a significant reduction of dropouts. The cost/benefit analysis is strongly in favor of the RPM-APD modality versus the traditional periodic hospital visit regime.
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