Remote patient treatment monitoring (RTM) can be an effective alternative to monthly clinic check-ins to assess patient status. Researchers from Fresenius Medical Care recently published a study in Kidney 360 that measured treatment outcome success with 6,343 peritoneal dialysis (PD) patients who used a remote monitoring platform.
Treatment for severe kidney failure often entails a fluid exchange process called dialysis. Dialysis performs the functions of a healthy kidney. During dialysis, fluid called dialysate is pumped or dripped into the body. Subsequently, after a prescribed amount of time, the dialysate is pumped or drained from the body, taking with it blood toxins and built-up excess fluid. Most people have heard of hemodialysis (HD), the common form of dialysis. Hemodialysis takes place in a hospital or treatment center three or four times a week. Each HD treatment takes three to five hours.
Many patients who need dialysis can choose peritoneal dialysis (PD) instead of hemodialysis. With peritoneal dialysis, dialysate is pumped or dripped into and then pumped or drained from the abdominal cavity (also called the peritoneal cavity). Patients have PD treatments daily, but they can do them at home or even when they travel. PD appeals to many patients because it is less disruptive than HD. Because patient compliance is always a concern with medical treatments, however, PD patients traditionally have to schedule monthly status visits at a hospital or clinic.
The researchers used Nekosoft’s PatientHub remote monitoring application. Patients used the PatientHub desktop or mobile app to enter treatment data and vital signs. The team broke the patients into three groups based on the number of treatment entries during a 30-day period. The groups were non-users, 1-to-15 treatment entries, and more than 15 entries. Relative treatment success was measured by the number of hospital admission days and “sustained technique failure.” Sustained technique failure meant the patients had to have traditional hemodialysis for six or more weeks.
The study found a positive reverse correlation between overall treatment success and the frequency of treatment entries. The groups with fewer treatment entries in PatientHub had higher hospital admission days and sustained technique failures than the groups with more entries. Patients who made the most entries had the fewest treatment failures.
The Fresenius study shows promise for remote treatment monitoring. There was no report of a control group of patients using PD who attended regular monthly clinic check-ins, so there are no conclusions comparing treatment success with clinic check-ins and RTM. Also, based on the data presented, one could conclude that compliant patients were more likely to be compliant treatment reporters. Even if treatment reporting compliance is low, however, that information can be useful as a signal to care teams that intervention may be necessary.
