DEVELOPING AN ASSISTED AUTOMATED PERITONEAL DIALYSIS PROGRAM IN WESTERN AUSTRALIA

D FORTNUM1, N HAWKINS2, G VANDEPEER3, A CHAKERA1,4

1Translational Renal Research Group, Harry Perkins Institute of Medical Research, Perth, Western Australia; 2Hospital in the Home, Sir Charles Gairdner Hospital, Perth, Western Australia; 3Fresenius Medical Care, Perth, Australia; 4Renal Unit, Sir Charles Gairdner Hospital, Perth, Western Australia

Aim: To develop an assisted automated peritoneal dialysis program in Western Australia

Background: Assisted peritoneal dialysis provides a model of care that has been successfully used to support patient choice and enable patients to stay on peritoneal dialysis. It also has the potential to provide significant cost saving. We describe the develop and initial results of an assisted automated peritoneal dialysis program developed in Western Australia

Methods: The assisted automated peritoneal dialysis model was developed in conjunction with the hospital in the home nursing service, the home dialysis provider (Fresenius Medical Care) and peritoneal dialysis staff. Evaluation methods included patient and staff questionnaires, assessment of dialysis complications and economic analyses.

Results: 15 participants received 594 episodes of care between 13th August 2015 and February 2017. The major reason for requiring assisted automated peritoneal dialysis was respite. Over 90% of patients and staff rated the service as valuable. Clinical outcomes reflected Charlson comorbidity scores (high score = poor outcome). 2 peritonitis episodes occurred during the study period. Initial calculations estimate that by using assisted automated peritoneal dialysis savings of over $600,000 were realised for WA health

Conclusions: Assistance with automated peritoneal dialysis provided by a visiting nursing service daily is a valuable treatment option for patients reducing the need for both hospital bed days and transfers to HD, providing significant cost savings.

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