Active eHealth interventions for patients on peritoneal dialysis showed mixed effectiveness, with high heterogeneity and low-quality evidence preventing a meta-analysis.
Systematic Review (n=1,334)
Do active eHealth interventions improve clinical and patient-reported outcomes in patients managing peritoneal dialysis at home?
Current evidence for active eHealth interventions in peritoneal dialysis is of low quality with mixed effectiveness, highlighting the need for more rigorous studies before widespread implementation.
Peritoneal dialysis (PD) requires patients to develop a variety of self-management skills in order to effectively deliver and manage their dialysis at home. eHealth interventions may provide patients with accessible information to develop the skills and knowledge they require to manage their treatment. This review aims to identify and evaluate ‘active’ eHealth interventions in supporting patients on PD. Six databases were included within the review using the terms Peritoneal Dialysis, eHealth, telemedicine and remote consultation. Studies which explored patients who were delivering PD, an intervention where the main component involved a digital device and required active engagement from patients were included. The primary outcomes examined were identified using the core outcomes recommended by the Standardised Outcomes in Nephrology in Peritoneal Dialysis initiative (PD infection, cardiovascular disease, mortality, PD failure and life participation). Hospitalisation rates were also considered as a primary outcome. Secondary outcomes included quality of life, patient skills, patient knowledge and satisfaction. Using the inclusion criteria, 15 studies (1334 participants) were included in the study. The effectiveness of eHealth interventions was mixed. Due to high heterogeneity, a meta-analysis was not possible, and quality of evidence was low. Risk of bias across the randomised studies was unclear but bias across non-randomised studies was identified as critical. There were no reported adverse effects of eHealth interventions within the included studies. Despite the high interest of eHealth interventions in PD, good quality evidence is needed to explore their effectiveness before a wider application of eHealth interventions.
Cartwright et al. (2020) conducted a systematic review in Peritoneal dialysis (n=1,334). Active eHealth interventions was evaluated on PD infection, cardiovascular disease, mortality, PD failure, life participation, and hospitalisation rates. Active eHealth interventions for patients on peritoneal dialysis showed mixed effectiveness, with high heterogeneity and low-quality evidence preventing a meta-analysis.