Key result
Telehealth with remote monitoring in PD may reduce HD transfers, hospitalizations, and in-person visits.
Why the study?
Telehealth interventions added to peritoneal dialysis care may improve patient autonomy, clinical outcomes, and cost-effectiveness, but evidence is heterogeneous and inconclusive.
Do telehealth interventions added to peritoneal dialysis care improve clinical outcomes, quality of life, and cost-effectiveness in patients on peritoneal dialysis?
Systematic Review (n=10,373)
Do telehealth interventions added to peritoneal dialysis care improve clinical outcomes, quality of life, and cost-effectiveness in patients on peritoneal dialysis?
Telehealth interventions, particularly remote patient monitoring, show potential to improve clinical outcomes and patient satisfaction in peritoneal dialysis, though high-quality prospective studies are needed.
BACKGROUND: Telehealth could potentially increase independency and autonomy of patients treated with peritoneal dialysis (PD). Moreover, it might improve clinical and economic outcomes. The demand for telehealth modalities accelerated significantly in the recent COVID-19 pandemic. We evaluated current literature on the impact of telehealth interventions added to PD-care on quality of life (QoL), clinical outcomes and cost-effectiveness. METHODS: An electronic search was performed in Embase, PubMed and the Cochrane Library in order to find studies investigating associations between telehealth interventions and: i. QoL, including patient satisfaction; ii. Standardized Outcomes in Nephrology (SONG)-PD clinical outcomes: PD-related infections, mortality, cardiovascular disease and transfer to hemodialysis (HD); iii. Cost-effectiveness. Studies investigating hospitalizations and healthcare resource utilization were also included as secondary outcomes. Due to the heterogeneity of studies, a meta-analysis could not be performed. RESULTS: Sixteen reports (N = 10,373) were included. Studies varied in terms of: sample size; design; risk of bias, telehealth-intervention and duration; follow-up time; outcomes and assessment tools. Remote patient monitoring (RPM) was the most frequently studied intervention (11 reports; N = 4982). Telehealth interventions added to PD-care, and RPM in particular, might reduce transfer to HD, hospitalization rate and length, as well as the number of in-person visits. It may also improve patient satisfaction. CONCLUSION: There is a need for adequately powered prospective studies to determine which telehealth-modalities might confer clinical and economic benefit to the PD-community.
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Biebuyck et al. (2022) conducted a systematic review in Peritoneal dialysis (n=10,373). Telehealth interventions vs. Standard peritoneal dialysis care was evaluated on Quality of life, SONG-PD clinical outcomes (PD-related infections, mortality, cardiovascular disease, transfer to HD), and cost-effectiveness. Telehealth interventions added to peritoneal dialysis care, particularly remote patient monitoring, may reduce transfer to hemodialysis, hospitalization rates, and in-person visits.
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