Feasibility and Acceptability of Using a Telehealth Platform to Monitor Cardiovascular Risk Factors in Hematopoietic Cell Transplantation Survivors at Risk for Cardiovascular Disease

Abstract

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in hematopoietic cell transplantation (HCT) survivors. In these patients, such risk factors as hypertension, diabetes, obesity, and physical inactivity are important modifiers of CVD risk. However, the period when HCT survivors are at greatest risk of developing these risk factors, and in turn CVD, coincides with a drop in engagement in survivorship care. We examined the feasibility and acceptability of a 4-week remote risk-based monitoring (blood pressure monitor, weight scale, pulse oximeter, glucometer) and management program in 18 (11 allogeneic and 7 autologous) HCT survivors at intermediate-high risk of CVD. The median patient age was 66 years (range, 53 to 74 years), 67% had hypertension, 22% had diabetes, 11% were obese (body mass index 30 kg/m 2 ), 56% were at intermediate risk of CVD, and 44% were at high risk of CVD. Weekly compliance with the remote monitoring schedule (3 readings/week using all devices) ranged from 72% in week 1 to 83% in weeks 2 to 4. Fifteen participants (83%) generated 86 alerts that were outside the predetermined range of normal; 63 of these readings (73%) normalized without intervention, and 23 (27%) necessitated triage by the study research nurse. Nearly all participants reported that the study kept them motivated and involved in their healthcare, and >85% agreed that the study supported their healthcare goals, helped them learn and manage their health conditions, and increased their access to healthcare. These findings may set the foundation for innovative risk-based and remote interventions to reduce the burden of CVD in this growing population of patients.

Patient and clinician use characteristics and perceptions of pulse oximeter use: A scoping review

“…Seven studies (43.8%) [8] , [9] , [10] , [11] , [12] , [13] , [14] were intervention studies that introduced a new telehealth system that included a pulse oximeter and gathered user experience feedback. Two studies were case studies assessing the usability of a pulse oximeter in a healthcare context [15] , [16] .…”

“…Four of the included studies (25%) examined the use of pulse oximeters as a tool to increase availability of care through pairing with a smartphone application [17] , [18] , [19] , [20] . Other applications included: as a diagnostic tool for children with pneumonia [15] , [16] ; a monitoring tool in paediatric telehomecare [11] ; remote risk-based monitoring tool for patients at risk of Cardiovascular disease (CVD) [8] , [10] ; a general monitoring tool for blood oxygenation levels [21] , [22] ; post-operative continuous vital sign monitoring for patients recovering from surgery [14] ; data capture and transmission to streamline clinical trials [9] ; long-term oxygen therapy (LTOT) optimization [12] ; and as a digital health intervention for managing Chronic Obstructive Pulmonary Disease (COPD) patients, either as a diagnostic tool or during rehabilitation [4] , [13] .…”

“…Chaniaud, Metayer, Megalakaki and Loup-Escande [22] used the ISO 9241-11 definition for usability as ‘the extent to which a product can be used by specified users to achieve specified goals’, and the remaining four studies did not define the term usability [13] , [15] , [17] , [18] . The second most frequently explored UX dimension was user acceptance / acceptability, which also varied in definition by study [8] , [10] , [12] , [16] . Lopez Segui et al, [11] used the UX dimension satisfaction , however, did not define what this meant in the context of using the system.…”

“…Questionnaires or surveys were most frequently used method, utilized in 12 out of the 16 included studies (75%) [8] , [9] , [10] , [11] , [12] , [13] , [14] , [17] , [18] , [19] , [21] , [22] . (See Fig.…”

Secondary Impact of the Coronavirus Disease 19 Pandemic on Patients and the Cellular Therapy Healthcare Ecosystem

“…However, among the 12 patients who enrolled, high adherence rates and reasonable patient satisfaction with the system were observed field 54 . Similarly, pilot studies to monitor cardiovascular risk factors among adult transplant recipients had also been tested, which showed good compliance among participating patients 55 .…”