The impact of a remote monitoring system of healthcare resource consumption in patients on automated peritoneal dialysis (APD): A simulation study

Kiyotaka Uchiyama, Naoki Washida, Nobuyuki Yube, Takahiro Kasai, Keisuke Shinozuka, Kohkichi Morimoto, Akihito Hishikawa, Hiroyuki Inoue, Hidenori Urai, Aika Hagiwara, Kentaro Fujii, Shu Wakino, Souzana Deenitchina, Hiroshi Itoh, Kiyotaka Uchiyama, Naoki Washida, Nobuyuki Yube, Takahiro Kasai, Keisuke Shinozuka, Kohkichi Morimoto, Akihito Hishikawa, Hiroyuki Inoue, Hidenori Urai, Aika Hagiwara, Kentaro Fujii, Shu Wakino, Souzana Deenitchina, Hiroshi Itoh

Abstract

Aims: Remote monitoring (RM) can improve management of chronic diseases. We evaluated the impact of RM in automated peritoneal dialysis (APD) in a simulation study.

Materials and methods: We simulated 12 patient scenarios with common clinical problems and estimated the likely healthcare resource consumption with and without the availability of RM (RM+ and RM- groups, respectively). Scenarios were evaluated 4 times by randomly allocated nephrologist-nurse teams or nephrologist-alone assessors.

Results: The RM+ group was assessed as having significantly lower total healthcare resource consumption compared with the RM- group (36.8 vs. 107.5 total episodes of resource consumption, p = 0.002). The RM+ group showed significantly lower "unplanned hospital visits" (2.3 vs. 11.3, p = 0.005), "emergency room visits" (0.5 vs. 5.3, p = 0.003), "home visits" (0.5 vs. 5.8, p = 0.016), "exchanges over the telephone" (18.5 vs. 57.8, p = 0.002), and "change to hemodialysis" (0.5 vs. 2.5, p = 0.003). Evaluations did not differ between nephrologist-nurse teams vs. nephrologist-alone assessors.

Conclusion: RM can be expected to reduce healthcare resource consumption in APD patients. .

Figures

Figure 1.. Study design. PD = peritoneal…
Figure 1.. Study design. PD = peritoneal dialysis; RM = remote monitoring.
Figure 2.. Comparisons of the frequency of…
Figure 2.. Comparisons of the frequency of healthcare resource consumption episodes between team-based evaluation and nephrologist-alone evaluation. No significant difference was observed between the two groups for any of the resources. RM = remote monitoring.

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