The healthcare ecosystem continues to battle the COVID-19 outbreak, as different parts of the country draw out unlock strategies. However, it has not been a smooth ride for non-COVIDpatient’s especially Chronic Kidney Disease (CKD) patients. According to a study, there are around 0.2 million kidney disease patients in India who require a total of 34 million dialysis sessionsevery year. Owing to mobility restrictions, it is important for kidney patients to really consider a lifestyle changing treatment and adoption of an alternative, more convenient way of carrying out therapies, such as home-based dialysis or Peritoneal Dialysis (PD).
PD is a form of standard dialysis therapy, which uses the peritoneum in a patients’ abdomen as the membrane through which fluid and dissolved substances are exchanged with the blood. It is a very convenient, home-based procedure which can be done by the patient following basic training and hygiene guidelines. Peritoneal Dialysis is of two types, Continuous Ambulatory Peritoneal Dialysis (CAPD) and Automated Peritoneal Dialysis (APD). CAPD involves manual fluid exchanges approx. 3-4 times a day, whereas, APD a more preferred option is performed at night with the assistance of mechanical devices.
PD should become a preferred choice of treatment therapy for many patients for its various advantages. Infact, now, with the deployment of IT-enabled patient monitoring systems or Remote Patient Management (RPM), homecare treatment such as PD is being embraced more than ever to aid both doctors and patients. This would not just help manage the disease better but also improve the overall quality of a patient’s life. APD with RPM is today made possible through cloud-based software such as Sharesource which provides seamless two-way communication between patient’s home and the hospital care team and helps to promptly identify patients with higher risk of complications. The cost/benefit analysis is strongly in favour of the APD with RPM modality versus APD without RPM.
Dr.Sree Bhushan Raju, Head of Nephrology at Nizam’s Institute of Medical Sciences (NIMS), Hyderabad commented,“With limitations on making clinics and hospital visits in the momentum circumstance, Chronic Kidney Disease (CKD) patients are confronting various issues to deal with their disease. Remote patient management (RPM) offers renal health care providers and patients the opportunities to embrace home dialysis therapies with the possibility to obtain better clinical outcomes. RPM is a framework for monitoring patients at home by digital wireless technology and extends the interactive contact of conventional clinical settings to include at a patient’s home. The ultimate goal would be to reduce hospital visits, improve quality of life while reducing healthcare resources, costs and benefit in terms of safety”.
RPM has the potential to improve patient outcomes undergoing PD by facilitating virtual clinical presence, enabling patient-generated clinical documentation and promoting self-monitoring. It enables the clinicians to closely monitor and interact with patients, provide feedback in real-time, and initiate early interventions such as prescription modifications and contextual clinical decision support. Thereby, allowing early detection and interventions to avoid hospital visits. RPM provides an opportunity to increase the uptake and technique survival of the home dialysis modalities by improving patient satisfaction and outcomes, leading to cost savings.People with CKD can now successfully use RPM without jeopardizing their safety due to Covid-19. The technology used in RPM is reliable and could really make a difference by connecting doctors and patients remotely.
“I had opted for PD before the pandemic. I feel destined enough that during these challenging times, I have an option to direct my dialysis from home. And now, with remote patient management, I am confident that my clinical issues are more proactively managed. Such advanced technologies are helping improve my PD therapy outcomes and enhancing home dialysis treatment” says aKidney Failure Patient.
A key to the success of home-based dialysis, particularly PD, is patient education and training. Thus, enabling PD through platforms like RPM in such challenging times would be highly feasible for patients to improve knowledge regarding self-care, feel the presence of the healthcare professionals remotely while on dialysis at home for better compliance with the dialysis regime and to feel connected with healthcare professionals. Thus, making the treatment remotely accessible and easy.
