Peritoneal Dialysis (PD) Patient and Nurse Preferences around Novel and Standard Automated PD Device Features.

Abstract

Despite offering greater lifestyle benefits to patients with end stage kidney disease (ESKD), adoption of peritoneal dialysis (PD) remains low globally, particularly among minorities and the socioeconomically disadvantaged. While automated PD (APD) affords a high potential for reducing the burden of kidney replacement therapy, understanding patient preferences is critical to guiding development of new and improved APD devices to better accommodate use in their daily lives. A quantitative cross-sectional survey study was performed using adaptive conjoint analysis (ACA) to quantify APD feature preferences among PD patients, PD nurses (RNs, and non-PD patients to ascertain the relative importance of eight specific cycler attributes including portability, noise, setup time, device size, setup directions, battery power, consumables, and PD RN control (PD RNs only), each with 2-3 descriptive feature levels. 42 PD patients, 24 non-PD patients, and 52 PD RNs were surveyed. Preference shares spanned nearly the entire range from 0% to 100%, indicating strong preference discrimination. For all groups, "Portability in the Home", "Noise Level", and "Setup time" were the most important features. PD patients gave highest priority to these features compared to other study participants, plausibly as features enabling improved lifestyle. A simulated "coat rack" style cycler with extended battery-power that was easy to move in the home, silent, required only 10-minute setup, and had a fully animated instruction screen was preferred by all groups > 90% compared to features present in existing cyclers. Addressing APD cycler technical and therapy-related issues to improve usability, comfort and convenience within the home may affect PD uptake and retention. Attention and priority must be given to patient centric APD cycler design directed at including features that improve quality of life for the device end-user.