Effects of a remote patient monitoring system for patients on automated peritoneal dialysis: a randomized crossover controlled trial

Purpose Remote patient monitoring (RPM) has contributed to improved patient-centered outcomes and prognosis in patients with end-stage renal disease on automated peritoneal dialysis (APD). However, evidence from prospective trials is lacking. Methods The participants (n = 15; median age: 65 years; males: 10; peritoneal dialysis vintage: 6.4 +/- 3.5 years) randomly received APD therapy using the Kaguya (R) APD system either with or without the connective use of the cloud-based RPM software Sharesource (R) for 12 weeks. The primary outcome was patient satisfaction assessed using a modified nine-item Treatment Satisfaction Questionnaire for Medication (TSQM-9) questionnaire. The secondary outcomes were healthcare resource consumption, the health-related quality of life (HRQOL) subscales assessed with the Kidney Disease Quality of Life-Short Form questionnaire, and clinical laboratory parameters. Results Significant improvements were observed in the TSQM-9 subscales of Effectiveness (64.4 +/- 18.8 vs. 57.8 +/- 18.8; P = 0.006) and Convenience (76.3 +/- 15.4 vs. 63.3 +/- 17.3; P < 0.001) in patients on Sharesource (R). Moreover, Sharesource (R) reduced the total amount of healthcare resource consumption (0.80 +/- 1.32 vs. 1.87 +/- 2.39 times/12 weeks; P = 0.02) and consultation time during regular monthly visits (813 +/- 269 vs. 1024 +/- 292 s; P < 0.001). A significant increase in ultrafiltration volume was found associated with more frequent modification of APD prescription in patients with Sharesource (R). Sharesource (R) also improved the HRQOL subscale of General Health and Vitality. Conclusion Sharesource (R) can improve patient-centered outcomes in patients on APD while reducing the treatment burden for both patients and medical staff.