Viviane Calice-Siva, Helen Ferreira, Gabriela Sevignani, Marcos Vieira, Raíssa Vodianitskaia, Fabiana Nerbass
2021 Nephrology, Dialysis and Transplantation  
Background and Aims In March 2020 to reduce the coronavirus spread in Brazil professional regulatory agencies allowed the telemedicine for distance patients' monitoring. All peritoneal dialysis (PD) patients from our center previously followed monthly in face-to-face visits were monitored by telephone call appointments since then. In this study, we aimed to investigate and compare the hospitalization rates before and during the telehealth assistance. Method Patients aged 18 years and older in
more » ... rch 2020 were included. We analysed total hospitalization rate and PD-related hospitalization rate (infectious, mechanical dysfunction and hypervolemia) 6-month before (first phase) and 6-month after (second phase) telehealth implementation. Results A total of 117 patients were included (male: 45%; age: 56.9 ± 16.2 years old; PD vintage: 15 (7–26) months; automated PD: 97%; diabetes: 45%). There were 15 hospital admissions in 13 patients (2 patients were admitted twice) during the first phase, resulting in an incident rate (IR)=23 per 1000 patients-month. In the second phase, the numbers increased to 34 admissions (3 due to covid-19) in 30 patients (1 patient admitted twice and another four times), IR=56 per 1000 patients-month. The total hospitalization incident rate ratio (IRR) was 2.43 (CI 95% 1.32 – 4.48). The total PD-related hospitalization increased from 4 (3 hypervolemia, 1 mechanical) to 20 (12 infectious, 3 mechanical; 5 hypervolemia) episodes during telehealth assistance, representing 26% to 59% of total hospitalizations. IRR for PD-related hospitalization was 5.5 (CI 95% 1.8 – 16.4). Conclusion After telehealth implementation, the risk of hospitalization raised significantly, mainly due to PD-relates causes that increased 5.5 times. Potential causes of this finding are lack of proper training for distance monitoring to patients and health care workers, life habits and routine of care modifications and social isolation. More studies are needed to assess the independent impact of telehealth on PD patients outcomes.
doi:10.1093/ndt/gfab101.0030 fatcat:vipo2msywndhlpll26apvdqge4