Peritoneal Dialysis (PD) Patient and Nurse Preferences around Novel and Standard Automated PD Device Features

Abstract

Key Points Adoption and extended time on peritoneal dialysis require patient input across a spectrum of needs, including automated PD (APD) device usability features that are less intimidating to patients and enable lifestyle advantages.Analysis of APD features critical to patients align with patient priorities identified in Standardized Outcomes in NephroloGy-PD: shorter setup time, mobility within the home, near silent operation, and modified APD size/orientation. Background Despite offering greater lifestyle benefits to patients with ESKD, adoption of peritoneal dialysis (PD) remains low globally, particularly among minorities and the socioeconomically disadvantaged. While automated PD (APD) affords a high potential for reducing the burden of KRT, understanding patient preferences is critical to guiding development of new and improved APD devices to better accommodate use in their daily lives. Methods A quantitative cross-sectional survey study was performed using adaptive conjoint analysis to quantify APD feature preferences among patients on PD, PD Registered Nurses (RNs), and non-PD patients to ascertain the relative importance of eight specific cycler attributes, including portability, noise, setup time, device size, setup directions, battery power, consumables, and PD RN control (PD RNs only), each with 2–3 descriptive feature levels. Results Forty-two patients on PD, 24 non-PD patients, and 52 PD RNs were surveyed. Preference shares spanned nearly the entire range from 0% to 100%, indicating strong preference discrimination. For all groups, “Portability in the Home,” “Noise Level,” and “Setup Time” were the most important features. Patients on PD gave highest priority to these features compared with other study participants, plausibly as features enabling improved lifestyle. A simulated “coat rack” style cycler with extended battery power that was easy to move in the home, silent, required only 10-minute setup, and had a fully animated instruction screen was preferred by all groups >90% compared with features present in existing cyclers. Conclusions Addressing APD cycler technical and therapy-related issues to improve usability, comfort, and convenience within the home may affect PD uptake and retention. Attention and priority must be given to patient-centric APD cycler design directed at including features that improve quality of life for the device end user.