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Pilot health technology assessment study: organizational and economic impact of remote monitoring system for home automated peritoneal dialysis

  • Nephrology - Original Paper
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Abstract

Purpose

Follow-up of automated peritoneal dialysis (APD) has been improved by data transmission by cellular modem and internet cloud. With the new remote patient monitoring (RPM) technology, clinical control and prescription of dialysis are performed by software (Baxter Claria-Sharesource), which allows the center to access home operational data. The objective of this pilot study was to determine the impact of RPM compared to traditional technology, in clinical, organizational, social, and economic terms in a single center.

Methods

We studied 21 prevalent APD patients aged 69 ± 13 years, on dialysis for a median of 9 months, for a period of 6 months with the traditional technology and 6 months with the new technology. A relevant portion of patients lived in mountainous or hilly areas.

Results

Our study shows more proactive calls from the center to patients after the consultation of RPM software, reduction of calls from patients and caregivers, early detection of clinical problems, a significant reduction of unscheduled visits, and a not significant reduction of hospitalizations. The analysis also highlighted how the RPM system lead to relevant economic savings, which for the health system have been calculated € 335 (mean per patient-month). With the social costs represented by the waste of time of the patient and the caregiver, we calculated € 685 (mean per patient-month).

Conclusion

In our pilot report, the RPM system allowed the accurate assessment of daily APD sessions to suggest significative organizational and economic advantages, and both patients and healthcare providers reported good subjective experiences in terms of safety and quality of follow-up.

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Funding

This study was not funded.

Author information

Authors and Affiliations

  1. Nephrology and Dialysis Unit, Hospitals of San Daniele del Friuli and Tolmezzo, ASUFC Friuli Venezia Giulia, Udine, Italy

    Gianpaolo Amici, Antonina Lo Cicero & Dino Romanini

  2. Facoltà di Economia, Università di Roma “Tor Vergata” and C.R.E.A. Sanità, Roma, Italy

    Daniela D’Angela & Federico Spandonaro

  3. Nephrology, Dialysis and Kidney Transplantation Center, San Bortolo Hospital, Vicenza and International Renal Research Institute, Vicenza, Italy

    Francesca K. Martino

Authors
  1. Gianpaolo Amici
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  2. Daniela D’Angela
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  3. Antonina Lo Cicero
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  4. Dino Romanini
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  5. Francesca K. Martino
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  6. Federico Spandonaro
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Corresponding author

Correspondence to Gianpaolo Amici.

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All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or regional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Amici, G., D’Angela, D., Lo Cicero, A. et al. Pilot health technology assessment study: organizational and economic impact of remote monitoring system for home automated peritoneal dialysis. Int Urol Nephrol 53, 1933–1940 (2021). https://doi.org/10.1007/s11255-021-02816-8

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  • DOI: https://doi.org/10.1007/s11255-021-02816-8

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