Wallace Eric L, Rosner Mitchell H, Alscher Mark Dominik, Schmitt Claus Peter, Jain Arsh, Tentori Francesca, Firanek Catherine, Rheuban Karen S, Florez-Arango Jose, Jha Vivekanand, Foo Marjorie, de Blok Koen, Marshall Mark R, Sanabria Mauricio, Kudelka Timothy, Sloand James A
Division of Nephrology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Division of Nephrology, University of Virginia Health System, Charlottesville, Virginia, USA.
Kidney Int Rep. 2017 Jul 29;2(6):1009-1017. doi: 10.1016/j.ekir.2017.07.010. eCollection 2017 Nov.
Remote patient management (RPM) offers renal health care providers and patients with end-stage kidney disease opportunities to embrace home dialysis therapies with greater confidence and the potential to obtain better clinical outcomes. Barriers and evidence required to increase adoption of RPM by the nephrology community need to be clearly defined. Ten health care providers from specialties including nephrology, cardiology, pediatrics, epidemiology, nursing, and health informatics with experience in home dialysis and the use of RPM systems gathered in Vienna, Austria to discuss opportunities for, barriers to, and system requirements of RPM as it applies to the home dialysis patient. Although improved outcomes and cost-effectiveness of RPM have been demonstrated in patients with diabetes mellitus and heart disease, only observational data on RPM have been gathered in patients on dialysis. The current review focused on RPM systems currently in use, on how RPM should be integrated into future care, and on the evidence needed for optimized implementation to improve clinical and economic outcomes. Randomized controlled trials and/or large observational studies could inform the most effective and economical use of RPM in home dialysis. These studies are needed to establish the value of existing and/or future RPM models among patients, policy makers, and health care providers.
远程患者管理（RPM）为肾脏医疗服务提供者和终末期肾病患者提供了机会，使他们能够更有信心地接受家庭透析治疗，并有可能获得更好的临床结果。肾脏病学界增加RPM采用率所需的障碍和证据需要明确界定。来自肾脏病学、心脏病学、儿科学、流行病学、护理学和健康信息学等专业的10名医疗服务提供者，他们在家庭透析和RPM系统使用方面有经验，齐聚奥地利维也纳，讨论RPM应用于家庭透析患者的机会、障碍和系统要求。尽管RPM在糖尿病和心脏病患者中已被证明能改善预后和成本效益，但在透析患者中仅收集到关于RPM的观察性数据。当前的综述聚焦于目前正在使用的RPM系统，RPM应如何融入未来的护理，以及优化实施以改善临床和经济结果所需的证据。随机对照试验和/或研究可以为RPM在家庭透析中的最有效和经济使用提供参考。需要这些研究来确定现有和/或未来RPM模式在患者、政策制定者和医疗服务提供者中的价值。
