Abstract
A FEASIBILITY STUDY OF REMOTE MONITORING OF CAPD PATIENT’S BLOOD PRESSURE ANDBLOOD GLUCOSE MEASUREMENTS VIA THE INTERNET.
G. Pylypchuk, P. Jacobson, C. McAllister University of Saskatchewan, St. Paul’s Hospital, Saskatoon, Saskatchewan. ChroniCare, Regina, Saskatchewan
The purpose of this study was to determine the feasibility of remotely monitoring blood pressure (BP) andglucose measurements in a cohort of diabetic patients receiving continuous ambulatory peritonealdialysis (CAPD). This can be achieved using BP monitors, glucometers and a ChroniCare appliance(HealthGate) to transmit the data to a secure internet server over a home telephone access. Tightcontrol of BP and blood sugar has been proven to improve both mortality and renal function in diabeticpatients with end stage renal disease. Physician access to real time BP and glucose measurementsvia the internet may allow for better control of these clinical parameters over time. Seventeen diabeticpatients currently monitored by St. Paul’s Hospital dialysis unit were selected to trial this equipment.After three initial hospital visits for baseline measurement of BP, glucose, hemoglobin A1c andequipment education, subjects were instructed to continue monitoring their BP and glucose levels atthe same intervals conducted at home. Subjects were instructed to download their data via telephoneline access on a weekly basis. Patients were provided with satisfaction questionnaires to becompleted at the end of the trial. The BP and glucose data could then be monitored in real time viainternet access from any location. Subjects began the study with a mean BP of 147/72 +/- 24/18mmHg, and a mean Hemoglobin A1c level of 7.6
±
1.2%. Baseline BP, glucose and Hemoglobin A1clevels were compared to values at the end of the study. The mean number of values downloaded per week was 11.9
±
11.2 with a range between 2 and 48. Of 17 subjects who began the trial, 15 havebeen successfully transmitting data on a regular basis. One subject refused to use the equipment after completing the initial visits and education and two have been experiencing technical difficulties. It waspossible to view the continuous trend of these vital signs in real time. Data was immediately availableusing internet access and can be viewed in both tabular and graphical formats. Limits may be set for each parameter to notify the physicians when dangerous values are recorded. This data may be usedin the future studies to make meaningful changes to the patients’ medication regimens. CAPDpatients only come to the hospital for follow-up every 2-3 months and it is hypothesized that this toolwill allow more rapid changes in treatment effects and patient compliance. Future studies are plannedto determine the long term effectiveness of this tool on BP and glucose control in this patientpopulation.
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