A Cloud-Based Home Management System for Patients with a left Ventricular Assist Device: A Case Report

Nomoto, S; Utsumi, M.; Minakata, Kenji

doi:10.5301/ijao.5000502

Cited by 6 publications

(23 citation statements)

References 7 publications

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“…There are 3 existing programs that offer some of the features of the app (eg, self-monitoring and reporting). Each program uses a different computing platform, including desktop (VADWatch, USA), 24 tablet (LVAD@home, Japan), 25 and mobile phone (VADable, USA). 26 However, none of these programs have described the purpose of its monitoring and reporting feature in the context of LVAD SM.…”

Section: Discussionmentioning

confidence: 99%

Development and Feasibility of Self-Management Application in Left-Ventricular Assist Devices

et al. 2018

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Despite major advancements in mechanical circulatory support, the self-management (SM) for patients with a left-ventricular assist device (LVAD) remains complex and challenging for patients and their caregivers. We have developed a mobile phone application (VAD Care App) to organize and simplify the LVAD SM process. This article describes the development and feasibility study of the app as an SM tool for LVAD patients and caregivers requiring support from ventricular assist device (VAD) coordinators. The specific aim was to evaluate the app's acceptability and usability and the users' competency. App features included an automated alert, data collection/reporting, and dynamic real-time interaction systems embedded in the LVAD SM process. Beta-testing of the prototype was completed by five adults. For the feasibility study, we employed a mixed-method descriptive research design involving nine patients and nine caregivers from two VAD centers in the Midwest. We asked them to use the app daily for more than 30 days and complete an app Evaluation Questionnaire and an interview. The questionnaire uses a five-point rating scale (1 = strongly disagree to 5 = strongly agree) evaluating usability, acceptability, and competency domains. Data generated from the questionnaires and interviews were analyzed with descriptive statistics and content analytic procedures. A total of 16 users (eight patients [all male] and eight caregivers [seven female]) aged 22 to 68 years completed the 30 day study. Median acceptability, usability, and competency scores were 4.6, 4.5, and 4.7, respectively. Based on the data, it is feasible for patients and caregivers to use an app as an LVAD SM tool warranting further research.

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Section: Discussionmentioning

confidence: 99%

Development and Feasibility of Self-Management Application in Left-Ventricular Assist Devices

et al. 2018

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“…However, in the field of LVAD therapy, no smartphone applications have been implemented in the routine aftercare of patients to date, and only very few pilot studies have been conducted, with very small patient groups . Within the framework of our study, a total of 13 patients gave very positive feedback after using a smartphone application for LVAD aftercare.…”

Section: Discussionmentioning

confidence: 97%

“…10 However, in the field of LVAD therapy, no smartphone applications have been implemented in the routine aftercare of patients to date, and only very few pilot studies have been conducted, with very small patient groups. 13,17,18 Within the framework of our study, a total of 13 patients gave very positive feedback after using a smartphone application for LVAD aftercare. During the 4-week test phase, the application was used intensively by all test persons, especially for the daily entry of relevant key parameters (eg, weight, INR, and symptoms).…”

Section: Discussionmentioning

confidence: 99%

Improved aftercare in LVAD patients: Development and feasibility of a smartphone application as a first step for telemonitoring

et al. 2019

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For the success of the treatment with a left ventricular assist device (LVAD), both adequate self‐management by the patient and an optimum level of support from the implanting hospital are crucial. A smartphone application has recently been developed within the framework of a European research project for the close monitoring of LVAD patients in order to improve upon their current aftercare situation. Using this new tool, different relevant parameters (eg, weight, international normalized ratio [INR], medication, LVAD parameters, symptoms, and photos of the driveline exit) can be sent daily or as required to a corresponding clinical application at the hospital for evaluation. The objective of this study was to monitor the functionality, acceptance, and usability of this smartphone application in LVAD patients. Prospective single‐center study: in total, 13 patients (60 ± 7 years, 92% male, 1027 ± 653 days after LVAD implantation) were requested to test the application for approx. 4 weeks. At the end of the study, all entered data were evaluated and the patients were questioned regarding the acceptance and the usability. During the study period of mean 34 ± 8 days, a total of 453 data records (mean 35 ± 7 per patient) arrived at the hospital. In addition, a total of 19 photos of the driveline exit site were also sent via smartphone. The clinical application registered a total of 160 conspicuities. These comprised 126 INR deviations (target range 2.3‐2.8) and 34 symptoms (mainly nosebleeds). The smartphone application functioned reliably, was well received by the patients and was graded highly for acceptance and usability. The results show that smartphone applications can definitely be used to improve aftercare in LVAD therapy in selected patients. Long‐term studies are now needed to investigate the extent to which complications can be prevented, healthcare costs reduced, and quality of life increased.

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“…We developed a cloud-based home medical management information-sharing system named as LVAD@home [8]. The LVAD@home system, an application designed to be used on iPad tablet computers, enables data on multiple factors, such as warfarin dose, selfchecked PT-INR, blood pressure, dietary intake, body condition, body temperature, body weight, urine color, and other physical conditions, to be recorded and shared daily between patients and care providers in real time.…”

Section: Introductionmentioning

confidence: 99%

Pharmacist-physician collaborative care for outpatients with left ventricular assist devices using a cloud-based home medical management information-sharing system: a case report

Katada

Yonezawa

Utsumi

et al. 2021

J Pharm Health Care Sci

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Background The standard anticoagulation therapy for patients implanted with left ventricular assist devices (LVADs) includes warfarin therapy. We developed a cloud-based home medical management information-sharing system named as LVAD@home. The LVAD@home system is an application designed to be used on iPad tablet computers. This system enables the sharing of daily information between a patient and care providers in real time. In this study, we reported cases of outpatients with LVADs using this system to manage anticoagulation therapy. Case presentation The patient, a man in his 40s with end-stage heart failure owing to non-ischemic dilated cardiomyopathy, underwent LVAD implantation and warfarin was started on postoperative day 1. He started to use LVAD@home to manage warfarin therapy after discharge (postoperative day 47). He sent his data to care providers daily. By using this system, the pharmacist observed his signs of reduced dietary intake 179 days after discharge, and after consulting the physician, told the patient to change the timing of the next measurement earlier than usual. On the next day, the prothrombin time-international normalized ratio increased from 2.0 to 3.0, and thus the dose was decreased by 0.5 mg. Four patients used this system to monitor warfarin therapy from October 2015 to March 2018. In these patients, the time in therapeutic range was 90.1 ± 1.3, which was higher than that observed in previous studies. Additionally, there were no thromboembolic events or bleeding events. Conclusions The cloud-based home management system can be applied to share real-time patient information of factors, including dietary intake that interact with warfarin. It can help to improve long-term anticoagulation outcomes in patients implanted with LVAD.

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A Cloud-Based Home Management System for Patients with a left Ventricular Assist Device: A Case Report

Cited by 6 publications

References 7 publications

Development and Feasibility of Self-Management Application in Left-Ventricular Assist Devices

Development and Feasibility of Self-Management Application in Left-Ventricular Assist Devices

Improved aftercare in LVAD patients: Development and feasibility of a smartphone application as a first step for telemonitoring

Pharmacist-physician collaborative care for outpatients with left ventricular assist devices using a cloud-based home medical management information-sharing system: a case report

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