Nephrology and Dialysis Unit, Hospitals of San Daniele del Friuli and Tolmezzo, ASUFC Friuli Venezia Giulia, Udine, Italy.
Facoltà di Economia, Università di Roma "Tor Vergata" and C.R.E.A. Sanità, Roma, Italy.
Int Urol Nephrol. 2021 Sep;53(9):1933-1940. doi: 10.1007/s11255-021-02816-8. Epub 2021 Mar 6.
Follow-up of automated peritoneal dialysis (APD) has been improved by data transmission by cellular modem and internet cloud. With the new remote patient monitoring (RPM) technology, clinical control and prescription of dialysis are performed by software (Baxter Claria-Sharesource), which allows the center to access home operational data. The objective of this pilot study was to determine the impact of RPM compared to traditional technology, in clinical, organizational, social, and economic terms in a single center.
We studied 21 prevalent APD patients aged 69 ± 13 years, on dialysis for a median of 9 months, for a period of 6 months with the traditional technology and 6 months with the new technology. A relevant portion of patients lived in mountainous or hilly areas.
Our study shows more proactive calls from the center to patients after the consultation of RPM software, reduction of calls from patients and caregivers, early detection of clinical problems, a significant reduction of unscheduled visits, and a not significant reduction of hospitalizations. The analysis also highlighted how the RPM system lead to relevant economic savings, which for the health system have been calculated € 335 (mean per patient-month). With the social costs represented by the waste of time of the patient and the caregiver, we calculated € 685 (mean per patient-month).
In our pilot report, the RPM system allowed the accurate assessment of daily APD sessions to suggest significative organizational and economic advantages, and both patients and healthcare providers reported good subjective experiences in terms of safety and quality of follow-up.
通过蜂窝调制解调器和互联网云传输数据，提高了自动化腹膜透析（APD）的随访效果。借助新的远程患者监测（RPM）技术，临床控制和透析处方由软件（百特 Claria-Sharesource）执行，这使中心能够访问家庭操作数据。本试点研究的目的是确定 RPM 在单一中心从临床、组织、社会和经济角度与传统技术相比的影响。
我们研究了 21 名年龄为 69±13 岁的现有 APD 患者，他们接受透析治疗的中位数为 9 个月，在传统技术下进行了 6 个月的研究，在新技术下进行了 6 个月的研究。相当一部分患者居住在山区或丘陵地区。
我们的研究表明，在使用 RPM 软件进行咨询后，中心对患者的主动呼叫更多，减少了患者和护理人员的呼叫，更早地发现了临床问题，显著减少了非计划性就诊次数，住院次数无显著减少。分析还强调了 RPM 系统如何带来相关的经济节省，为卫生系统计算的节省额为 335 欧元（每位患者每月平均）。以患者和护理人员浪费的时间来表示社会成本，我们计算的成本为 685 欧元（每位患者每月平均）。
在我们的试点报告中，RPM 系统能够准确评估每日 APD 治疗，提出具有显著组织和经济优势的方案，患者和医疗保健提供者都报告了在安全性和随访质量方面良好的主观体验。
