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Description and outcomes of a staff-assisted peritoneal dialysis program in the United States. | LitMetric

AI Article Synopsis

  • A staff-assisted peritoneal dialysis (PD) program was developed and implemented in the U.S. to help patients who face challenges with self-care due to physical, cognitive, or psychosocial issues.
  • From August 2020 to October 2022, the program expanded from 2 to 16 centers and provided support for 73 out of 121 referred patients, with a median of 5 visits lasting an average of 8 days without any reported infections.
  • The program showed high discharge rates, with 93% of assisted patients continuing PD independently, achieving 6- and 12-month survival rates of 71% and 57%, respectively.

Article Abstract

Background: Staff-assisted peritoneal dialysis (PD) can help overcome barriers to self-care but is not yet available in the United States (US). We developed and implemented a staff-assisted PD program that fits within current regulatory and cost restraints in the US healthcare environment.

Methods: Patient care technicians (PCTs) were trained on PD procedures and troubleshooting common problems. The program expanded from two centers in August 2020 to sixteen by October 2022. We described the logistic elements of program delivery, and patient and treatment outcomes for patients discharged by end of April 2023, with a cohort follow up until October 2023.

Results: A total of 121 patients were referred to the program. The most common indications for referral were physical function limitations, cognitive impairment, and psychosocial challenges. Staff assistance was provided for 73 patients. Mean age was 72 (standard deviation 14) years. A total of 604 visits were delivered, with a median 5 (interquartile range [IQR] 3-10, range: 1-49) visits per patient. Median duration of assistance was 8 (IQR: 2-21, range: 1-84) days. Assistance was most frequently needed for PD treatment setup and for observing and directing the technique. No peritonitis events or exit-site infections were reported. Sixty-eight patients (93%) were discharged on PD without staff assistance. The 6- and 12-month survival of PD without assistance was 71% and 57%, respectively.

Conclusions: Staff-assisted PD for limited time periods is operationally feasible with PCTs in the US and can support transitioning and maintaining patients on PD. NCT04319185.

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Source
http://dx.doi.org/10.1177/08968608241259607DOI Listing

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