de Fijter Caroline W H, Jorritsma Wiard, Rutten Len, Vermeulen Asja, Zuijderduijn Danielle
Department of Nephrology, OLVG Amsterdam, Amsterdam, The Netherlands.
Department of Quality and Improvement, OLVG Amsterdam, Amsterdam, The Netherlands.
Clin Kidney J. 2025 Apr 15;18(5):sfaf102. doi: 10.1093/ckj/sfaf102. eCollection 2025 May.
eHealth technology bridging home and hospital care was shown to allow efficient use of healthcare resources in automated peritoneal dialysis (APD). Data on eHealth applications in patients on continuous ambulatory PD (CAPD) are scarce. We evaluated implementation of a smartphone app enabling remote patient care in CAPD.
In this prospective observational cohort study, all PD patients were informed and could choose whether or not to use the app. A confounder-controlled analysis was performed to compare outcomes between users and non-users. App users rated experienced support, feeling of safety and need for interim hospital visits. Renal nurses participated in a structured interview.
A total of 36 of 72 participating patients used the app. The app was associated with a 90% decrease in hospital admission days [95% confidence interval (CI) 51-98] and a 62% decrease in hospital admissions (95% CI 21-83). There was no clear effect on the number of emergency room visits, consultations and patient-reported outcomes. Patient's satisfaction with the app was high (mean rating 4.8 on a 1-5 scale), experiencing a decrease in the need for hospital visits and almost all felt safer. Nurses appreciated a time-efficient improvement in quality of patient-focused care.
Implementation of the app maintained and even increased interaction between patients and the PD team time-efficiently. The app was associated with fewer hospitalization days and was rated positively by patients and nurses. The safe sharing of photos feature reduced interim hospital visits, presumably lowering the carbon footprint. We embedded the app in our practice as a form of value-based healthcare.
电子健康技术连接家庭和医院护理，已被证明可有效利用自动化腹膜透析（APD）中的医疗资源。关于持续性非卧床腹膜透析（CAPD）患者使用电子健康应用程序的数据很少。我们评估了一款支持CAPD远程患者护理的智能手机应用程序的实施情况。
在这项前瞻性观察性队列研究中，所有腹膜透析患者均被告知并可选择是否使用该应用程序。进行了混杂因素控制分析，以比较使用者和非使用者的结局。应用程序使用者对获得的支持、安全感和临时住院需求进行了评分。肾脏科护士参与了结构化访谈。
72名参与研究的患者中，共有36名使用了该应用程序。该应用程序使住院天数减少了90%[95%置信区间（CI）51 - 98]，住院次数减少了62%（95%CI 21 - 83）。对急诊就诊次数、会诊次数和患者报告的结局没有明显影响。患者对该应用程序的满意度很高（1 - 5分制下平均评分为4.8），感觉住院需求减少，几乎所有人都感到更安全。护士们认可在以患者为中心的护理质量方面有了高效的提升。
该应用程序的实施有效且高效地维持甚至增加了患者与腹膜透析团队之间的互动。该应用程序与更少的住院天数相关，患者和护士对其评价积极。照片安全共享功能减少了临时住院次数，可能降低了碳足迹。我们将该应用程序纳入我们的实践，作为基于价值的医疗保健的一种形式。
