Talbot Benjamin, Farnbach Sara, Tong Allison, Chadban Steve, Sen Shaundeep, Garvey Vincent, Gallagher Martin, Knight John
Renal and Metabolic Division, The George Institute for Global Health, University of New South Wales, Sydney, Australia.
Concord Clinical School, The University of Sydney, New South Wales, Australia.
Can J Kidney Health Dis. 2022 Mar 21;9:20543581221084499. doi: 10.1177/20543581221084499. eCollection 2022.
Numerous factors influence patient recruitment to, and retention on, peritoneal dialysis (PD), but a major challenge is a perceived "inaccessibility" to treating clinicians. It has been suggested that remote patient monitoring (RPM) could be a means of improving such oversight and, thereby, uptake of PD.
To describe patient and clinician perspectives toward RPM and the use of applications (Apps) suitable for mobiles, tablets, or computers to support the provision of PD care.
Qualitative design using semi-structured interviews.
All patient participants perform PD treatment at home under the oversight of an urban PD unit in Sydney, Australia. Patient and clinician interviews were conducted within the PD unit.
14 participants (5 clinicians [2 nephrologists, 3 PD nurses] and 9 patients treated with PD).
Semi-structured interviews were conducted using interview guides tailored for clinician and patient participants. Transcripts were coded and analyzed by a single researcher using thematic analysis.
Six themes were identified: perceived benefits of RPM implementation (offering convenience and efficiency, patient assurance through increased surveillance, more complete data and monitoring adherence), uncertainty regarding data governance (protection of personal data, data reliability), reduced patient engagement (transfer of responsibility leading to complacency), changing patient-clinician relationships (reduced patient-initiated communication, the need to maintain patient independence), increased patient and clinician burden (inadequate technological literacy, overmanagement leading to frequent treatment changes), and clinician preference influencing patient behavior.
The interviews were conducted in English only and with participants from a single urban dialysis unit, which may limit generalizability.
For patients and clinicians, advantages from the use of RPM in PD may include increased patient confidence and assurance, improved treatment oversight, more complete data capture, and overcoming barriers to data documentation. Careful patient selection and patient and clinician education may help to optimize the benefits of RPM, maintain patient independence, and reduce the risks of patient disengagement. The use of an App may support RPM; however, participants expressed concerns about increasing the burden on some patients through the use of unfamiliar technology.
CH62/6/2019-028.
诸多因素影响腹膜透析（PD）患者的招募及维持治疗，但一个主要挑战是患者感觉难以接触到治疗医生。有人提出远程患者监测（RPM）可能是改善此类监督从而提高PD治疗接受度的一种方式。
描述患者和医生对RPM以及使用适用于手机、平板电脑或计算机的应用程序（Apps）以支持提供PD护理的看法。
采用半结构化访谈的定性设计。
所有参与研究的患者均在澳大利亚悉尼一个城市PD单位的监督下在家中进行PD治疗。患者和医生访谈在PD单位内进行。
14名参与者（5名医生[2名肾病学家，3名PD护士]和9名接受PD治疗的患者）。
使用为医生和患者参与者量身定制的访谈指南进行半结构化访谈。由一名研究人员使用主题分析法对访谈记录进行编码和分析。
确定了六个主题：实施RPM的感知益处（提供便利和效率、通过加强监测让患者放心、获取更完整的数据以及监测依从性）、数据治理的不确定性（个人数据保护、数据可靠性）、患者参与度降低（责任转移导致自满）、医患关系的变化（患者主动沟通减少、需要保持患者独立性）、患者和医生负担增加（技术素养不足、管理过度导致频繁更改治疗方案）以及医生偏好影响患者行为。
访谈仅用英语进行，且参与者来自单一城市透析单位，这可能会限制研究结果的普遍性。
对于患者和医生而言，在PD中使用RPM的益处可能包括增强患者信心和安全感、改善治疗监督、更完整地获取数据以及克服数据记录方面的障碍。仔细挑选患者以及对患者和医生进行教育可能有助于优化RPM的益处、保持患者独立性并降低患者退出治疗的风险。使用应用程序可能会支持RPM；然而，参与者对通过使用不熟悉的技术增加部分患者的负担表示担忧。
CH62/6/2019 - 028。
