Directed Use of REmote Patient Management System AMia to Achieve Prescribed Dry Weight

Safety Issues Clinical Trial

— DREAM-APD  

Official title:

Directed Use of REmote Patient Management System AMia to Achieve Prescribed Dry Weight

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT04002440
• Other study ID #: 180492
• Status: Active, not recruiting
• Phase: N/A
• Start date: November 8, 2018
• Est. completion date: April 2022

Study information

• Verified date: August 2021
• Source: University of California, San Diego
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Among ambulatory peritoneal dialysis patients, does use of the Baxter AMIA peritoneal dialysis cycler with SHARESOURCE connectivity platform achieve dry weight targets better than use of the Baxter Home Choice Pro cycler.

Description:

The remote patient management system Baxter AMIA automated peritoneal dialysis system with SHARESOURCE connectivity platform incorporates innovative technology (two-way remote connectivity, touch screen controls, voice guidance) to record patient treatments which are then able to be transmitted to their dialysis clinic for review and monitoring in near real-time. This has tremendous potential clinical utility given the struggles to achieve dry weights for most peritoneal dialysis patients using other systems, where typically, management regarding fluid balance is reviewed and revised only monthly. The new technology is the only device cleared in the US with patient-centric features. Abstracts available have demonstrated that AMIA can improve efficiency of patient training and focus PD nursing time towards proactive tasks to help patients. There has also been insight into how remote patient management systems like AMIA can be used to objectively monitor patient compliance or catheter function above and beyond subjective endorsement from patients. However, with new technology comes new training for patient and staff (nurses, physicians) without understanding if interfacing with this new patient-centric featured technology improves patient-centric clinical outcomes. The new AMIA and SHARESOURCE programs may also require additional nurse and physician provider time to monitor data in real-time and to react to these data, which may incur additional expense to medical practices. Thus, it is imperative to demonstrate the utility of the AMIA and SHARESOURCE programs for important improvement in patient management, which may ultimately translate into improved clinical outcomes (e.g. fewer hospital admissions, less heart failure, improved quality, and length of life).

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 28
• Est. completion date: April 2022
• Est. primary completion date: November 30, 2021
• Accepts healthy volunteers: No
• Gender: All
• Age group: 21 Years and older

Eligibility

Inclusion Criteria:

• Adults aged > 21 years with ESRD on peritoneal dialysis

Exclusion Criteria:

• Unable to commit to 12 months of monitoring.
• Unable to stand safely on scale for weight
• Hospitalization for heart failure, volume overload, or cardiovascular disease within the last 3 months.
• Peritonitis within the past 3 months.
• Not responsible for self-care of peritoneal dialysis (proxy care will be excluded).
• Patients residing in a nursing home or other institutionalized individuals.
• Inability or unwillingness to provide informed consent (lacks decision making capacity)
• Alcohol, substance use, or other social conditions which preclude close follow-up and reliable participation, in the opinion of the primary nephrology physician or study investigator.

Related Conditions & MeSH terms

• Efficacy
• Safety Issues

Intervention

Combination Product:
• AMIA with SHARESOURCE Connectivity Platform
The investigators will conduct a randomized, cross-over study in peritoneal dialysis patients in which patients are randomized to either Home Choice Pro (which remains the most widely used Baxter cycler) versus treatment with the Baxter AMIA automated peritoneal dialysis system with SHARESOURCE connectivity.

Device:
• HomeChoice PRO
Usual care

Locations

Country	Name	City	State
United States	Home Dialysis Therapies of San Diego	Chula Vista	California
United States	Home Dialysis Therapies of San Diego	San Diego	California

Sponsors (4)

Lead Sponsor	Collaborator
University of California, San Diego	Baxter Healthcare Corporation, Home Dialysis Therapies of San Diego, Scripps Health

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	3 month average of difference between the actual vs. prescribed dry weight	The investigators will evaluate the average difference between the actual dry weight vs. prescribed dry weight achieved through use of Baxter AMIA automated peritoneal dialysis system with SHARESOURCE connectivity compared to use of HomeChoicePRO.	3 months
Secondary	Nursing burden related to use of AMIA with SHARESOURCE	The investigators will observe the number of nursing time hours per month dedicated to patient care for patients using AMIA with SHARESOURCE compared to patients using HomeChoicePRO.	12 months
Secondary	Patient Quality of Life while using AMIA with SHARESOURCE: Kidney Disease and Quality of Life -36 questionaire	The investigators will assess quality of life scores using the Kidney Disease and Quality of Life -36 questionaire survey of patients using AMIA with SHARESOURCE compared to patients using HomeChoicePRO. The survey assesses 5 areas pertaining to quality of life on dialysis which include 1) physical component score 2) mental component score 3) burden 4) symptoms 5) effects. Patient answers are compared to their national demographic and reported on a scale of 0-100. The higher the score the better. The scores for each component will be reported and tracked separately.	12 months