Pediatric nephrology (Berlin, Germany) · 2022
Outcomes and perception of cloud-based remote patient monitoring in children receiving automated peritoneal dialysis: a prospective study.
Наблюдательное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Chan Eugene Yu-Hin, Liu Mei-Shan, Or Po-Chu, Ma Alison Lap-Tak
Аннотация
BACKGROUND: Remote patient monitoring (RPM) for automated peritoneal dialysis (APD) may improve clinical outcomes. Paediatric data, however, remain extremely scarce.
METHODS: We conducted a prospective observational study of children (0-18 years) receiving APD with cloud-based RPM over two 24-week periods (pre- and post-RPM). Primary outcomes were unplanned hospitalizations and fluid management. Children receiving APD without RPM (non-RPM) were included as control.
RESULTS: Seven patients (6 females) receiving APD were enrolled in the RPM programme at 11.3 years (IQR 2.6-17.1). Main indications for RPM included history of fluid overload (n = 3) and non-adherence (n = 2). Ten children were included in the non-RPM group (6 females; 16.9 years, IQR 12.8-17.6). Four patients (57.1%, 95% CI 22.5-100%) experienced fewer unplanned hospitalizations and 5 patients (71.4%, 95% CI 34.1-100%) had shorter hospital stays during the post-RPM period. The hospitalization rates and length of stay were reduced by 45% and 42%, respectively. The higher hospitalization rates among the RPM group, compared to the non-RPM group, were no longer observed following implementation of RPM. There was a significant increase in ultrafiltration (565.6 ± 248.7 vs. 501.7 ± 286.6 ml/day, p = 0.03) and reduction in systolic blood pressure (114.1 ± 12.6 vs. 119.9 ± 11.19 mmHg, p = 0.02) during the post-RPM period. All patients demonstrated satisfactory adherence. Although quality of life (PedsQL 3.0 ESRD module) was not different pre- and post-RPM, all patients agreed in the questionnaires that the use of RPM improved their quality of life and sense of security.
CONCLUSIONS: In conclusion, RPM in children receiving APD is associated with fewer and shorter unplanned hospitalizations, improved fluid management and favourable adherence to PD. A higher resolution version of the Graphical abstract is available as Supplementary information.
METHODS: We conducted a prospective observational study of children (0-18 years) receiving APD with cloud-based RPM over two 24-week periods (pre- and post-RPM). Primary outcomes were unplanned hospitalizations and fluid management. Children receiving APD without RPM (non-RPM) were included as control.
RESULTS: Seven patients (6 females) receiving APD were enrolled in the RPM programme at 11.3 years (IQR 2.6-17.1). Main indications for RPM included history of fluid overload (n = 3) and non-adherence (n = 2). Ten children were included in the non-RPM group (6 females; 16.9 years, IQR 12.8-17.6). Four patients (57.1%, 95% CI 22.5-100%) experienced fewer unplanned hospitalizations and 5 patients (71.4%, 95% CI 34.1-100%) had shorter hospital stays during the post-RPM period. The hospitalization rates and length of stay were reduced by 45% and 42%, respectively. The higher hospitalization rates among the RPM group, compared to the non-RPM group, were no longer observed following implementation of RPM. There was a significant increase in ultrafiltration (565.6 ± 248.7 vs. 501.7 ± 286.6 ml/day, p = 0.03) and reduction in systolic blood pressure (114.1 ± 12.6 vs. 119.9 ± 11.19 mmHg, p = 0.02) during the post-RPM period. All patients demonstrated satisfactory adherence. Although quality of life (PedsQL 3.0 ESRD module) was not different pre- and post-RPM, all patients agreed in the questionnaires that the use of RPM improved their quality of life and sense of security.
CONCLUSIONS: In conclusion, RPM in children receiving APD is associated with fewer and shorter unplanned hospitalizations, improved fluid management and favourable adherence to PD. A higher resolution version of the Graphical abstract is available as Supplementary information.