Compliance with automated peritoneal dialysis.

Compliance in peritoneal dialysis is reported as being a significant problem. In CAPD, the percentage of non-compliant patients varies between 10 and 40%. In APD the phenomenon seems to be more limited, at 15% - 20%. We considered 23 patients who had been on APD for more than 3 months.The dialytic treatment was performed using the Home Choice Pro device to record all the parameters of the dialysis session. The last 30 days of treatment were considered in the assessment of compliance, evaluating differences in daytime and night-time volumes between the prescription and the actual treatment,the length of the night-time session, and the days of treatment. As regards volume and duration, no differences were found compared to the dialytic prescriptions. For the days of treatment, a differencewas onlyfound in 3 patients: 2 self-administered patients missed day of therapy out of 30, and in both cases the missed tretment was ageed with the Centre; non-compliance was only found in 1 patient (4,3%), whose treatment was performed by the family, and who missed 4 days out of 30.

Communication as a teamwork tool in peritoneal dialysis.

The growing complexity of the problems which have to be faced in providing a peritoneal dialysis service, such as giving assistance over a territory, consideration of the needs of the individual and the greater emphasis on the prevention of complications, makes multidisciplinary teamwork necessary, with the interaction of various skills. In order to succeed, teamwork requires the identification of clear objectives which are shared by all the members of the team. The various skills can best be exploited by defining roles and agreeing common aims and objectives so that the team can provide the patient with holistic treatment, which recognises the needs of the individual rather than the needs of the illness. Active cohesion between the various components is only possible through a defined communication strategy and an on-going transfer of knowledge.