Development of a Novel Remote Patient Monitoring System

Maguire, Roma; Ream, Emma; Richardson, Alison; Connaghan, John; Johnston, Bridget; Kotronoulas, Grigorios; Pedersen, Vivi; McPhelim, J.; Pattison, Natalie; Smith, Allison G.; Webster, Lorraine K.; Taylor, Anne; Kearney, Nora

doi:10.1097/ncc.0000000000000150

Cited by 107 publications

(110 citation statements)

References 54 publications

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“…The media used within telehealth interventions were heterogeneous: 11 studies appraised telephone-based interventions, [30-32,34,35,42,43,47,49-51], 5 studies related to primarily Web-based interventions, [33,36,39,40,48], 1 study evaluated email communication [37], and 5 looked at interventions using handheld monitoring devices [38,41,44-46]. The purpose of the interventions was diverse and included: 15 which supported patients through treatment; 6 which monitored symptoms [36,38,41,44-46]; and 9 which provided psychological support, information, advice or self-management strategies [33-35,39,40,42,43,47,49]. For 2 studies, telehealth acted as a form of communication between patients and HCPs at various stages of their journey [37,48] and 5 interventions replaced clinic visits for follow-up patients [30-32,50,51].…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the aims of the 22 studies, 9 explored the views of patients and health care professionals as to the use of telehealth [30,41,44-48,50,51], 9 the experience of only patients [31,32,34-36,38,40,42,43], and 4 the experience of both patients and family members [33,37,39,49]. For 11 studies, the primary aim was to test the acceptability and feasibility of telehealth interventions [33-35,38,41-45,47,48]: 8 focused primarily on the experience of intervention use [30-32,40,46,49-51], and 3 aimed to explore the potential benefits of telehealth [36,37,39].…”

Section: Resultsmentioning

confidence: 99%

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Cancer Survivors’ Experience With Telehealth: A Systematic Review and Thematic Synthesis

Cox¹,

Lucas²,

Marcu³

et al. 2017

J Med Internet Res

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256

261

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BackgroundNet survival rates of cancer are increasing worldwide, placing a strain on health service provision. There is a drive to transfer the care of cancer survivors—individuals living with and beyond cancer—to the community and encourage them to play an active role in their own care. Telehealth, the use of technology in remote exchange of data and communication between patients and health care professionals (HCPs), is an important contributor to this evolving model of care. Telehealth interventions are “complex,” and understanding patient experiences of them is important in evaluating their impact. However, a wider view of patient experience is lacking as qualitative studies detailing cancer survivor engagement with telehealth are yet to be synthesized.ObjectiveTo systematically identify, appraise, and synthesize qualitative research evidence on the experiences of adult cancer survivors participating in telehealth interventions, to characterize the patient experience of telehealth interventions for this group.MethodsMedline (PubMed), PsychINFO, Cumulative Index for Nursing and Allied Health Professionals (CINAHL), Embase, and Cochrane Central Register of Controlled Trials were searched on August 14, 2015, and March 8, 2016, for English-language papers published between 2006 and 2016. Inclusion criteria were as follows: adult cancer survivors aged 18 years and over, cancer diagnosis, experience of participating in a telehealth intervention (defined as remote communication or remote monitoring with an HCP delivered by telephone, Internet, or hand-held or mobile technology), and reporting qualitative data including verbatim quotes. An adapted Critical Appraisal Skill Programme (CASP) checklist for qualitative research was used to assess paper quality. The results section of each included article was coded line by line, and all papers underwent inductive analysis, involving comparison, reexamination, and grouping of codes to develop descriptive themes. Analytical themes were developed through an iterative process of reflection on, and interpretation of, the descriptive themes within and across studies.ResultsAcross the 22 included papers, 3 analytical themes emerged, each with 3 descriptive subthemes: (1) influence of telehealth on the disrupted lives of cancer survivors (convenience, independence, and burden); (2) personalized care across physical distance (time, space, and the human factor); and (3) remote reassurance—a safety net of health care professional connection (active connection, passive connection, and slipping through the net). Telehealth interventions represent a convenient approach, which can potentially minimize treatment burden and disruption to cancer survivors’ lives. Telehealth interventions can facilitate an experience of personalized care and reassurance for those living with and beyond cancer; however, it is important to consider individual factors when tailoring interventions to ensure engagement promotes benefit rather than burden.ConclusionsTelehealth interventions can provide cancer sur...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Cancer Survivors’ Experience With Telehealth: A Systematic Review and Thematic Synthesis

Cox¹,

Lucas²,

Marcu³

et al. 2017

J Med Internet Res

Self Cite

256

261

View full text Add to dashboard Cite

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“…Testing technology-based interventions is an important future direction for cancer symptom management research. 49 …”

Section: Discussionmentioning

confidence: 99%

Development of a Symptom Management Intervention

et al. 2017

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Background Little is known about cancer patient and family caregiver preferences for the content and format of non-pharmacologic interventions. Revising interventions based on patient and caregiver feedback before implementation may improve intervention feasibility and acceptability, especially in the context of advanced cancer. Objectives To obtain feedback from advanced, symptomatic lung cancer patients and their family caregivers on the content and format of a non-pharmacologic symptom management intervention under development. The intervention blended evidence-based cognitive-behavioral and emotion-focused strategies to reduce physical and psychological symptoms. Methods Semi-structured qualitative interviews were conducted with 21 advanced, symptomatic lung cancer patients and caregivers. Participants reviewed handouts regarding intervention components and provided feedback. Results Patients and caregivers desired intervention components that addressed the patient’s high symptom burden such as education regarding treatment side-effects and the provision of various coping tools. Offering interventions with a brief or flexible length and delivering them via telephone were other suggestions for enhancing intervention acceptability. Participants also preferred an equal focus on patient and caregiver concerns and a more positive intervention framework. Conclusions Intervention preferences of advanced lung cancer patients and caregivers underscore the severity of the disease and treatment process and the need to adapt interventions to patients with high symptom burden. These preferences may be incorporated into future intervention trials to improve participant recruitment and retention. Implications for Practice Nurses can modify interventions to meet the needs of advanced, symptomatic lung cancer patients and caregivers. For example, flexibility regarding intervention content and length may accommodate those with significant symptoms.

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“…The greatest perceived benefits of the more widespread adoption of mHealth solutions included improvements in health care system processes, the collection and retrieval of crucial medical data, and the ability of patients to manage chronic conditions [61]. Specifically, some of these studies have shown that mobile monitoring of cancer patients can be effective, may reduce chemotherapy- or radiotherapy-related toxicity [38-41], and can even help to maintain maximum dose intensity in patients treated with oral capecitabine [42]. Although eHealth technologies and mHealth apps have so far had little impact on public health outcomes [37], it has been argued that their contribution to creating a more efficient and safer health care process can be maximized in a highly computerized setting [5,21,37].…”

Section: Discussionmentioning

confidence: 99%

“…However, there has been a clear focus on chronic diseases (63%, primarily diabetes) and only 5% relate to cancer, as pointed in a recent review, although these have so far had little impact on public health outcomes [37]. A number of studies of the mobile monitoring of cancer patients have been published, including one randomized clinical trial, and the results have shown it can be effective, may reduce chemotherapy- or radiotherapy-related toxicity [38-41], and can even help to maintain maximum dose intensity in patients treated with oral capecitabine [42]. The patients involved in all of these studies generally felt reassured to be monitored at home, and the health professionals found that the system helped in the management of symptoms and promotion of timely interventions.…”

Section: Introductionmentioning

confidence: 99%

Integrating mHealth in Oncology: Experience in the Province of Trento

Galligioni¹,

Piras²,

Galvagni³

et al. 2015

J Med Internet Res

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BackgroundThe potential benefits of the introduction of electronic and mobile health (mHealth) information technologies, to support the safe delivery of intravenous chemotherapy or oral anticancer therapies, could be exponential in the context of a highly integrated computerized system.ObjectiveHere we describe a safe therapy mobile (STM) system for the safe delivery of intravenous chemotherapy, and a home monitoring system for monitoring and managing toxicity and improving adherence in patients receiving oral anticancer therapies at home.MethodsThe STM system is fully integrated with the electronic oncological patient record. After the prescription of chemotherapy, specific barcodes are automatically associated with the patient and each drug, and a bedside barcode reader checks the patient, nurse, infusion bag, and drug sequence in order to trace the entire administration process, which is then entered in the patient’s record. The usability and acceptability of the system was investigated by means of a modified questionnaire administered to nurses. The home monitoring system consists of a mobile phone or tablet diary app, which allows patients to record their state of health, the medications taken, their side effects, and a Web dashboard that allows health professionals to check the patient data and monitor toxicity and treatment adherence. A built-in rule-based alarm module notifies health care professionals of critical conditions. Initially developed for chronic patients, the system has been subsequently customized in order to monitor home treatments with capecitabine or sunitinib in cancer patients (Onco-TreC).ResultsThe STM system never failed to match the patient/nurse/drug sequence association correctly, and proved to be accurate and reliable in tracing and recording the entire administration process. The questionnaires revealed that the users were generally satisfied and had a positive perception of the system’s usefulness and ease of use, and the quality of their working lives. The pilot studies with the home monitoring system with 43 chronic patients have shown that the approach is reliable and useful for clinicians and patients, but it is also necessary to pay attention to the expectations that mHealth solutions may raise in users. The Onco-TreC version has been successfully laboratory tested, and is now ready for validation.ConclusionsThe STM and Onco-TreC systems are fully integrated with our complex and composite information system, which guarantees privacy, security, interoperability, and real-time communications between patients and health professionals. They need to be validated in order to confirm their positive contribution to the safer administration of anticancer drugs.

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Development of a Novel Remote Patient Monitoring System

Cited by 107 publications

References 54 publications

Cancer Survivors’ Experience With Telehealth: A Systematic Review and Thematic Synthesis

Cancer Survivors’ Experience With Telehealth: A Systematic Review and Thematic Synthesis

Development of a Symptom Management Intervention

Integrating mHealth in Oncology: Experience in the Province of Trento

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