Understanding how remote patient monitoring supports patients with end stage kidney disease uptake and sustainability of peritoneal dialysis.

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Supporting patients and clinicians to be confident with home treatment is one of the most important attributes influencing patient selection toward home dialysis. Our hypothesis is that remote patient monitoring for patients considering peritoneal dialysis can support patient decision-making, increase preferences for peritoneal dialysis and enhance treatment characteristics of peritoneal dialysis to align more closely with patient-centered care. To test this hypothesis, this study will explore patient and clinician perceptions of remote patient monitoring to support choosing and sustaining peritoneal dialysis as a treatment modality. The study will seek to understand clinician views of remote patient monitoring to establish how better to support clinicians to recommend peritoneal dialysis. Ultimately, if remote patient monitoring is identified to be acceptable to patients and clinicians, This study could then lead to rigorous testing of remote patient monitoring in clinical trials. In this study we will conduct a qualitative project involving clinicians who provide peritoneal dialysis care and patients who have experienced peritoneal dialysis and their caregivers in three dialysis centres in New Zealand. The study objectives are: • Objective 1: Summarise the current evidence for experiences of patients and caregivers regarding remote patient monitoring (systematic review and thematic synthesis of qualitative studies). • Objective 2: Determine factors related to remote patient monitoring that influence clinician (nephrologists and peritoneal dialysis nurses) practice at an individual and practice level (semi-structured interview study). • Objective 3: Determine factors related to remote patient monitoring that support patient choice and maintenance of peritoneal dialysis (semi-structured interview study) This study will advance knowledge about how remote patient monitoring supports patient choice and maintenance of peritoneal dialysis. This study will enable recommendations about remote patient monitoring in dialysis practice. The findings may encourage inclusion of remote patient monitoring to support uptake of peritoneal dialysis in lower income countries throughout Asia and the Western /Pacific regions for patients who may not have access to alternative dialysis treatments.

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