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Compared to hemodialysis, patients on peritoneal dialysis live longer and healthier, have a higher quality of life and cost approximately $40,000 less to the healthcare system per patient per year. However, only 18% of dialysis patients in Canada currently use peritoneal dialysis because patients often feel isolated from the healthcare team and lack the confidence to manage treatments by themselves. This study will assess a telehome monitoring system (eQ Connectâ„¢), allowing for up-to-date data transmission and digital interaction between the patients at home and their healthcare team. From the patients' perspective, this technology is an easier way to communicate with their healthcare providers, track their treatment and supplies, and receive training and support. From the providers' perspective, eQ Connectâ„¢ delivers up-to-date patient data and provides an efficient way to keep track of the patients' progress. This intervention has the potential to improve the patients' clinical outcomes, quality of life, reduce the costs of dialysis to the healthcare system and ultimately empower patients to start and stay on peritoneal dialysis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Telehome Monitoring | Experimental | Patients in this arm will use the telehome monitoring device (a mobile tablet) to support them with their peritoneal dialysis (communication, treatment tracking, supply tracking, appointment reminders, educational content). |
|
| Standard of Care | No Intervention | Patients in this arm use the standard of care for peritoneal dialysis, which is simple telephone communication and using pen and paper log to track their treatments and supplies. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Telehome Monitoring | Device |
|
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| Measure | Description | Time Frame |
|---|---|---|
| Composite clinical outcome | The primary outcome is a composite of technique failure (switching to hemodialysis for ≥12 weeks), infections (peritonitis, exit-site, tunnel) and hospital encounters (ER visits, hospitalizations). | 1 year (plus 12 weeks for complete follow-up of technique failure) |
| Measure | Description | Time Frame |
|---|---|---|
| Health-related Quality of Life | This study will utilize the Kidney Disease Quality of Life-36 (KDQOL-36) Instrument and EQ-5D to assess HRQOL. | 1 year |
| Time spent communicating | This measure captures the time a patient spends communicating with the healthcare team. This is measured through automated telephone logs and paper telephone logs that are documented by nurses. For patients in the intervention arm, investigators will also obtain the duration of video calls and amount of time spent on the message screen (number of minutes). We will also capture the number of messages that are sent on the telehome monitoring device. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Arsh K Jain, MD | University of Western Ontario, Canada | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Royal Columbian Hospital - Fraser Health Authority | New Westminster | British Columbia | V3L 3W7 | Canada | ||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28486991 | Derived | Jeffs L, Jain AK, Man RH, Onabajo N, Desveaux L, Shaw J, Hensel J, Agarwal P, Saragosa M, Jamieson T, Wong I, Maione M, Bhatia RS. Exploring the utility and scalability of a telehomecare intervention for patients with chronic kidney disease undergoing peritoneal dialysis-a study protocol. BMC Nephrol. 2017 May 10;18(1):155. doi: 10.1186/s12882-017-0557-y. |
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| 1 year |
| Number of missed appointments | Investigators will examine the number of appointments that a patient has missed, which is documented through a scheduling software from the clinic. | 1 year |
| Nurse Overtime hours | Investigators deliver care for the patients. The number of hours worked over-time are documented in a telephone log manually, which includes the patient's name, reason for call and call duration. | 1 year |
| Number of clinic visits | The number of clinic visits will be collected through scheduling software from the PD clinic. | 1 year |
| Hospitalization Days | Investigators will compare the length of hospitalizations (in days) between intervention and control group. | 1 year |
| Nursing Costs | Investigators will compare costs by applying each centre's hourly nursing cost to the number of hours nurses spent communicating with the patient (derived from "time spent communicating" measure). | 1 year |
| Healthcare Utilization Costs | Investigators will use the Case Costing Macro at ICES to compare the health utilization costs between two groups, including costs from emergency room visits and hospitalizations. (This is only applicable to the Ontario Centres). | 1 year |
| Dialysis Supplies Costs | Investigators will compare the cost of supplies between the intervention and control group. | 1 year |
| Seven Oaks General Hospital |
| Winnipeg |
| Manitoba |
| R2V 3M3 |
| Canada |
| QEII Health Sciences Centre - Nova Scotia Health Authority | Halifax | Nova Scotia | B3H 1V7 | Canada |
| St. Joseph's Healthcare Hamilton | Hamilton | Ontario | L8G 5E4 | Canada |
| Kingston General Hospital | Kingston | Ontario | K7L 2V7 | Canada |
| London Health Sciences Centre | London | Ontario | N6A 5W9 | Canada |
| Trillium Health Partners - Mississauga Hospital | Mississauga | Ontario | L4Z 3N6 | Canada |
| Mackenzie Health | Richmond Hill | Ontario | L4E 4L6 | Canada |
| Scarborough Health Network - General Hospital | Scarborough Village | Ontario | M1P 2V5 | Canada |
| Humber River Hospital | Toronto | Ontario | M3M 0B2 | Canada |
| St. Paul's Hospital | Saskatoon | Saskatchewan | S7M 0Z9 | Canada |
| ID | Term |
|---|---|
| D007676 | Kidney Failure, Chronic |
| ID | Term |
|---|---|
| D051436 | Renal Insufficiency, Chronic |
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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