PUNE: 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-COVID patients, 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 sessions every 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. In fact, 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 a higher risk of complications. The cost/benefit analysis is strongly in favor of the APD with RPM modality versus APD without RPM.
Commenting on the deployment of RPM says Dr. Tarun Jeloka, Associate Director – Nephrology, Aditya Birla Hospital, Pune mentioned that “In the current flow of pandemic circumstances, Chronic Kidney Disease (CKD) patients are at a higher risk of contracting COVID-19 virus. Today with the progression in innovation, we can distantly deal with the state of the patients and roll out fundamental improvements in their treatment. Remote patient management (RPM) uses digital technologies to collect health data from a patient’s home, and electronically transmit the information to healthcare providers in a different location for assessment and recommendation. The goal of RPM is to minimize clinic visits, as well as cost-saving and time-saving through reduced travel. Remote monitoring in chronic disease management may significantly improve an individual’s quality of life and avoid complications”.
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.
“With the onset of the pandemic, my doctors introduced me to a remote patient management platform to improve health status and disease prevention. Leveraging technological advancement like RPM was a good decision as it provides many clinical and economic benefits in real-time. PD has made my dialysis procedure simpler and convenient and through RPM, the method becomes even more personalized as it is being closely monitored by my doctor,” says a Kidney 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.
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