Table 3.

Summary of Subthemes and Illustrative Quotes for Simplifying Treatment Processes Theme

Subtheme	Content	Illustrative Quote
Easier Use
User-friendly setup and instruction	Patients described the experience of treatment setup as time consuming and requiring a number of steps. Recommendations included that cyclers be easier to use, eg, step-by-step guidance, more user-friendly operational buttons, tubing extensions that enable increased patient mobility, and that mobile apps could be developed to assist; Optional format choice was welcomed with a touch screen and/or voice control. Cleaning or infection concerns were not mentioned by any patients.	“It tells me when my treatment is going to be over, which is really good, I never knew with the other machine, it doesn’t say, you know because it didn’t talk and it didn’t have, it wasn’t hooked to the internet.” Patient 319 (57-y-old female patient who lives alone, RM user) “The voice would be better cause my vision is blurred. For people who can’t see that well, the voice is better” Patient 319 (57-y-old female patient who lives alone, RM user)
Simplify Management of Supplies
Ordering and delivery	Patients generally described the process of ordering and receiving supplies as simple and user friendly. Some referenced challenges in moving heavy bags while others mentioned reminders from clinic staff to order. However, frequent changes in prescriptions for treatment may have cost implications for the patient.	“If they don’t place their order by a certain time, then they’re contacted …to remind them, and if they still don’t place the order then (the manufacturer) contacts our clinic to say, ‘these people haven’t yet placed their order.’ So then I contact them, and remind them, or ask them if they need any help…and go from there, but, every 2 weeks they’re either placing their order or receiving their order.” HCP 119 (57-y-old female nurse, non-RM user)
Training for PD
	The training provided to RM and non-RM users was viewed positively and as appropriate. It varied from one site to another and often included trial runs with cyclers at home and in the hospital under close clinical supervision and support, home visits, training of an informal supporter etc. All stressed the importance of making sure patients were comfortable and confident with the treatment.	“It usually takes you know 3 to 5 days to do that, it’s usually conducted largely in the patient’s home although it can be also done here in the hospital. And in terms of proficiency, they do an oral test, they don’t do a written exam, at the end of their training.” HCP 155 (63-y-old male nephrologist, non-RM user) “I think they did a good job cause well when I first started I did the manuals first and I wasn’t sure about the cycler …it was by my nurse from the clinic. I thought she did a really good job…They do go over a lot of stuff when I go twice a month to the clinic and so they still go over things with me to make sure I’m still doing it right.” Patient 517 (45-y-old female patient, non-RM user)
Fewer Things for Patients to Do
Recording vitals (eg, blood pressure, weight as part of daily treatments)	Recording vitals was the most frequently discussed item by HCPs (both RM and non-RM) and non-RM patients and caregivers. The daily recording of vitals is generally viewed as a small burden to patients that could be alleviated through electronic RM recording, however, not all RM systems have implemented this feature and some patients liked manual recording to preserve some treatment control or engagement.	“It just seems that we use a lot of paper doing the things and then you have to remember to take them with you…it would be kind of official and less time wasted [if] he [the nephrologist] could already look at it, you know.” Patient 532 (47-y-old female patient without RM) “…I would still like to retain some kind of control over taking my blood pressure and my weight every day. Other than that, if they can just take the rest of the data that would be wonderful.” Patient 796 (53-y-old female patient without RM)

Abbreviations: HCP, health care provider; PD, peritoneal dialysis; RM, remote management.