56 - Telehealth Survey of Providers and Caregivers of Children On Peritoneal Dialysis during the COVID-19 Pandemic

Poster Number: 56
Publication Number: 56.340

Stephanie L. Clark, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Melisha G. Hanna, University of Colorado School of Medicine, Aurora, CO, United States; Brandy Begin, OHSU/Doernbecher Children's Hospital, Portland, OR, United States; Heidi G. De Souza, Children's Hospital Association, Lenexa, KS, United States; Kathleen Mallett, Children's Mercy Kansas City, Kansas City, MO, United States; Troy Richardson, Analytics, Lenexa, KS, United States; Megan Esporas, Vynamic, Durham, NC, United States; Ariana Bowie, Phoenix Children's Hospital, Phoenix, AZ, United States; Laura Castellanos Reyes, Cohen Children's Medical Center, New Hyde Park, NY, United States; Alicia Neu, Johns Hopkins University School of Medicine, Baltimore, MD, United States; BRADLEY A. WARADY, CHILDREN'S MERCY KANSAS CITY, KANSAS CITY, MO, United States

Background: There has been growing support for adoption of telehealth (TH) services in pediatric populations but slow adoption. Children on chronic peritoneal dialysis (PD) represent a vulnerable population that could benefit from increased use of TH services. The COVID-19 pandemic prompted rapid adoption of TH services among pediatric centers participating in The Children’s Hospital Association’s Standardizing Care to Improve Outcomes in Pediatric ESKD (SCOPE) Collaborative.

Objective: We sought to explore the experience of both pediatric PD providers and caregivers of patients receiving PD care at home and using TH services during the COVID-19 pandemic.

Design/Methods: We developed a survey to explore the experience of both pediatric PD providers and caregivers of patients receiving PD care at home and using TH services during the COVID-19 pandemic. The surveys were distributed to providers and caregivers at centers participating in the SCOPE collaborative between October 2020 and March 2021.

Results: We obtained responses from 27 out of 53 total SCOPE centers for a center response rate of 50.9% that included 177 completed surveys (130 surveys from providers and 45 caregiver surveys). Provider respondents included attending physicians (n=48, 27.4%), fellow physicians (n=7, 4%), nurse managers (n=8, 4.6%), NP/APNs (n=4, 2.3%), PD nurses (n=30, 17.1%), dieticians (n=21, 12%), and social workers (n=12, 6.9%). When asked about the benefits of TH visits, the top provider responses included the ability to observe the home, family centered, ability for all team members to meet with the family together, and the ability to review medications with access to the medication bottles. When caregivers were asked about the benefits of TH, the top responses consisted of no travel, visit takes less time, easier to take care of other children, more comfortable for the patient, and do not need to take time off from work. The majority (58%) of caregivers who wanted to participate in TH visits felt that their child’s needs were addressed in a manner that was similar to an in-person visit. However, only 51% of respondents desired additional TH visits in the future. Providers and caregivers agreed that PD TH visits are family centered (p = 0.296) and that major challenges include the lack of a physical exam (p < 0.001) and the inability to meet in-person (p=0.002).Conclusion(s): TH could be a productive and viable visit option for children on PD; however, making this a successful, permanent part of routine care will require a standardized approach that is individualized by shared decision making between providers and caregivers.
Table 1Demographic information
Table 2Ratings of telehealth visits by caregivers (among caregivers who have had a TH visit in the last 6 months) and providers