FP586HEALTH CARE PROFESSIONALS’ AND PATIENTS’ PERCEPTIONS OF AN APD CYCLER DEVELOPMENT WITH REMOTE MONITORING: AN OPPORTUNITY TO IMPROVE STANDARD OF CARE?

Abstract

Introduction and Aims: Peritoneal dialysis (PD) is underutilised despite providing a safe, effective, home-based treatment. Barriers still exist from the healthcare professional (HCP) and patient perspectives. Patient concerns include the ability to manage an APD cycler and long term therapy. Maintaining aseptic technique, monitoring clinical status between clinic visits, changing prescriptions and therapy compliance are HCP concerns that impact choice of home dialysis. Improvements to PD cycler technology along with remote patient monitoring may help to further simplify automated peritoneal dialysis (APD) for patients and HCPs. This study aimed to understand the importance of features of current APD cyclers and evaluate HCP and patient perceptions of advancements in APD cycler technology. Methods: Forty-minute telephone interviews and web-based surveys (22 questions) including video APD cycler representations, were conducted with 214 nephrologists, 138 nephrology/renal nurses (with experience using APD), and 193 CKD patients from the UK and US. Study participants were asked to compare an existing cycler and a cycler in development with variable device design, information screen, user interface and connectivity to/from the clinic. HCP and patient respondents were also asked to assess their level of agreement with statements relating to clinical utility. Results: HCP respondents rated all attributes of the new APD cycler higher than the existing one. The new cycler scored higher for data collection and management (5.9 vs. 4.2, p<0.01), user interface (5.6 vs. 4.3, p<0.01), ease of use (5.6 vs. 4.8, p<0.01), and portability (4.8 vs. 4.6). Additionally, more HCP respondents agreed with all new cycler usability statements compared to existing technology. In particular, 86% of HCPs (p<0.1) agree that the new APD cycler with remote patient monitoring “gives clinicians more confidence and control when managing their patients”. Patient respondents also more often agreed that the new cycler was easy to use (89% new vs. 80% current), that the user interface would help reduce operator error (91% vs. 67%), that users would more rapidly achieve an adequate level of competence in performing APD with the cycler (76% vs. 65%) and that the cycler gives patients more confidence to start and stay on PD (80% vs. 69%). Conclusions: HCPs and patients reviewed a new APD cycler design with remote monitoring capability in terms of reviewing APD therapy and remote cycler programming. Advantages were identified in terms of usability and data management. These findings correlate with the potential barriers to the wider use of PD in many countries. It is possible that once this cycler with remote patient monitoring is used in clinical practice it may make PD more deliverable from the point of view of both patients and HCPs.