The impact of a remote monitoring system of healthcare resource consumption in patients on automated peritoneal dialysis (APD): Asimulation study .

Kiyotaka Uchiyama,Keisuke Shinozuka,Akihito Hishikawa,Aika Hagiwara,Nobuyuki Yube,Takahiro Kasai,Naoki Washida,Kentaro Fujii,Hiroyuki Inoue,Shu Wakino,Kohkichi Morimoto,Hidenori Urai,Hiroshi Itoh,Souzana Deenitchina

doi:10.5414/cn109471

Kiyotaka Uchiyama, Keisuke Shinozuka + Show 12 more

Open Access

https://doi.org/10.5414/cn109471

Copy DOI

Abstract

Aims: Remote monitoring (RM) can improve management of chronic diseases. We evaluated the impact of RM in automated peritoneal dialysis (APD) in a simulation study. Materials and methods: We simulated 12 patient scenarios with common clinical problems and estimated the likely healthcare resource consumption with and without the availability of RM (RM+ and RM– groups, respectively). Scenarios were evaluated 4 times by randomly allocated nephrologist-nurse teams or nephrologist-alone assessors. Results: The RM+ group was assessed as having significantly lower total healthcare resource consumption compared with the RM– group (36.8 vs. 107.5 total episodes of resource consumption, p = 0.002). The RM+ group showed significantly lower “unplanned hospital visits” (2.3 vs. 11.3, p = 0.005), “emergency room visits” (0.5 vs. 5.3, p = 0.003), “home visits” (0.5 vs. 5.8, p = 0.016), “exchanges over the telephone” (18.5 vs. 57.8, p = 0.002), and “change to hemodialysis” (0.5 vs. 2.5, p = 0.003). Evaluations did not differ between nephrologist-nurse teams vs. nephrologist-alone assessors. Conclusion: RM can be expected to reduce healthcare resource consumption in APD patients.

Highlights

In Japan, the number of dialysis patients has exceeded 320,000 [1], leading to increased healthcare expenditure in hemodialysis (HD) clinics
Total healthcare resource consumption was significantly lower in the remote monitoring (RM)+ group (36.8 ± 5.4 events) than in the RM– group (107.5 ± 26.7 events) across all scenarios (Student’s t-test p = 0.002) (Table 1, Supplementary Table 1, and Supplementary Figure 1)
Our study shows that RM is expected to improve efficiencies of care and reduce healthcare resource consumption in Automated peritoneal dialysis (APD) patients facing common clinical problems

Summary

Introduction

In Japan, the number of dialysis patients has exceeded 320,000 [1], leading to increased healthcare expenditure in hemodialysis (HD) clinics. Automated peritoneal dialysis (APD) involves the use of a device that performs PD exchanges for the patient while the patient is asleep, which improves the patient’s quality of life (QoL) and experience of dialysis [2, 3]. Remote monitoring (RM) has been successfully used to manage diseases such as chronic obstructive pulmonary disease and congestive heart failure [4, 5, 6]. The ability to remotely load a patient’s prescription and observe their response to therapy through monitoring of drainage volumes, vital signs, and other parameters can be expected to reduce complications and adverse events, and thereby reduce healthcare resource consumption [9]

Methods

Results

Conclusion