An early experience of Check List to Improve Patient Self-care and Product Defect Report in Continuous Ambulatory Peritoneal Dialysis (CLIP-SP) study

Abstract

An increase in number of peritoneal dialysis patients and demand for peritoneal dialysis products following implementation of “PD First” policy in Thailand has led to logistics supply chain challenges and inherent product quality problems. Available evidences suggested that defective peritoneal dialysis products may predispose the patients to peritonitis. Thailand Clinical Practice Guideline for Peritoneal Dialysis 2017 recommends the patients to check peritoneal dialysis products themselves before use. In this report, we present our early experience from the Check List to Improve Patient Self-care and Product Defect Report in Continuous Ambulatory Peritoneal Dialysis study, a cluster randomized trial conducted in 22 peritoneal dialysis centers in Thailand. Patients from 11 randomly selected sites were asked to use the check list to report any product quality defects. The peritoneal dialysis product check list required patients to check the expiration date, glucose concentration, clarity, color, and integrity of bags of peritoneal dialysis fluid as well as the peritoneal dialysis connectors prior to each use. Among 338 patients who had received the check list from 5 centers, 28 returned the reports, detecting 8 defects out of 3960 products in total (0.2%). Although the obtained check list reports were not perfectly completed, they were comprehensible and provided important information on product defects which meant that the check list was simple enough for the patients and/or caregivers to follow. In conclusion, despite low response rate and incomplete report in this early phase analysis, the check list provides important information on product defects while an impact of these defects on peritoneal dialysis outcomes requires a further investigation.