Telemonitoring and home hospitalization in patients with chronic obstructive pulmonary disease: study TELEPOC

Rubio, Manuel Mirón; Fernández, Rocío Ceballos; Pastor, Inmaculada Parras; Iloro, Amaya Palomo; Félix, Borja Manuel Fernández; Miralles, Jenifer Medina; López, Esther Zamudio; Pastor, Javier González; Lorente, Caridad Amador; Hortelano, Nazaret Mena; Sánchez, Alejandro Domínguez; Alonso-Viteri, Soledad

doi:10.1080/17476348.2018.1442214

Cited by 20 publications

(10 citation statements)

References 24 publications

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“…In the recent COPD Patient Management European Trial (COMET) that investigated a COPD disease management intervention that included remote telemonitoring in patients with severe COPD, acute care hospitalization days and mortality were significantly lower in the disease management group [ 16 ]. Other analyses have found inconsistent impact of telemonitoring on hospitalizations [ 17 - 19 ] and quality of life [ 17 - 20 ], a trend toward reduced costs [ 20 , 21 ], improved physical activity but no effect on physical capacity or dyspnea [ 22 ], and no effect on length of hospital stay or mortality [ 19 ]. Most reviewers concluded that despite some encouraging results, additional evidence from larger, high-quality studies is needed before definitive conclusions and recommendations can be made on the benefits of telemonitoring programs for patients with COPD [ 12 , 19 , 20 , 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

Performance of an eHealth (NOMHAD) System Comprising Telemonitoring, Telenotification, and Telecoaching for Patients With Multimorbidity: Proof-of-Concept Study

Chacornac¹,

Faoro²,

Texereau³

et al. 2022

JMIR Form Res

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Background Management of patients with multiple chronic diseases is a growing public health challenge, especially in rural sectors where access to physicians may be limited. Connected medical devices monitoring vital signs, associated with eHealth program and structured telephone support, may improve complex patient management through early detection of disease complications, positive impact on patients’ health, and health resources consumption optimization. Objective The aim of this study was to evaluate the technical performance and user experience of the NOMHAD eHealth system in patients with multimorbidity. Methods This was a pilot, single-arm, interventional study. Patients with multimorbidity with any combination of chronic heart failure (CHF), chronic obstructive pulmonary disease, and diabetes were followed for 80-100 days using the NOMHAD eHealth system. This system used connected devices telemonitoring symptoms and vital signs (eg, body weight, oxygen saturation, pulse rate, blood pressure, and blood glucose), associated with structured telecoaching and educational support by call center nurses. An overall risk indicator (ORI) was automatically computed after each data teletransmission. The ORI was color coded; green indicated no action required; yellow, orange, and red (low to high priority, respectively) generated telenotifications and indicated to the nurses the need for a telecoaching action. Each ORI was calculated by combining 7 clinical stability system indicators based on symptom questionnaires and vital signs. Technical accuracy of the system was assessed by comparing system-generated ORIs with ORIs recalculated from raw data. Ease of use, usefulness, satisfaction, and acceptability of the system were assessed through patient adherence to self-assessments, and through self-administered questionnaires to patients, call center nurses, and physicians. Results A total of 23 patients were enrolled in this study and participated between April 2016 and March 2017 at 5 study centers in France. All patients were successfully equipped and evaluable for analysis. Mean age was 68.5 (SD 10.4) years and most patients were men (n=20). The most common multimorbidity was CHF + diabetes (n=15), followed by patients with all 3 diseases (n=5). Mean effective follow-up was 78.7 (SD 24.2) days. The system generated 6263 ORIs, as several ORIs could be generated on a single day for any patient. Overall system sensitivity was 99.2% (95% CI 98.9-99.4) and overall specificity was 91.3% (95% CI 87.7-94.1). Most patients (20/23, 87%) were satisfied with the system and agreed that it helped them to better understand and manage their diseases, and 19/23 (83%) valued the nurse regular contacts. Nurses and physicians were generally satisfied with the system and considered it useful. All users indicated they would agree to long-term use of the system. Conclusions This study provides evidence that the NOMHAD eHealth system is accurate, acceptable, informative, and feasible for patients with multimorbidity, supporting further investigation of its clinical benefits. Trial Registration Agence Nationale de Sécurité du Médicament et des Produits de Santé 2015-A01106-43; https://ictaxercb.ansm.sante.fr/Public/index.php

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Section: Introductionmentioning

confidence: 99%

Performance of an eHealth (NOMHAD) System Comprising Telemonitoring, Telenotification, and Telecoaching for Patients With Multimorbidity: Proof-of-Concept Study

Chacornac¹,

Faoro²,

Texereau³

et al. 2022

JMIR Form Res

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“…Three hospital@home models used a medication management system (31) or symptom monitoring system (33,34). Few studies described hospital@home models that included wearables, biosensors, or more innovative digital tools, for example, a skin patch (VitalConnect) was used to monitor vital parameters along with machine learning to monitor health conditions (10), and electronic devices were used to measure vital signs (heart rate and blood pressure) (37,49,50).…”

Section: Digital Tools and Technologiesmentioning

confidence: 99%

“…Here, hospital@home technologies could allow for remote monitoring of the development of a condition to avoid unnecessary use of health services or hospitalization (55). Few studies are available showing that hospital@home care is less expensive than hospital care (37). Thus, the optimization of limited resources in hospitals becomes possible through hospital@home care models (26).…”

Section: Strengths Weaknesses Opportunities and Threatsmentioning

confidence: 99%

Digital health as an enabler for hospital@home: A rising trend or just a vision?

Denecke

May

Borycki

et al. 2023

Front. Public Health

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BackgroundHospital@home is a model of healthcare, where healthcare professionals actively treat patients in their homes for conditions that may otherwise require hospitalization. Similar models of care have been implemented in jurisdictions around the world over the past few years. However, there are new developments in health informatics including digital health and participatory health informatics that may have an impact on hospital@home approaches.ObjectivesThis study aims to identify the current state of implementation of emerging concepts into the hospital@home research and models of care; to identify strengths and weaknesses, opportunities, and threats associated with the models of care; and to suggest a research agenda.MethodsWe employed two research methodologies, namely, a literature review and a SWOT (strengths, weaknesses, opportunities, and threats) analysis. The literature from the last 10 years was collected from PubMed using the search string “hospital at home” OR “care at home” OR “patient at home.” Relevant information was extracted from the included articles.ResultsTitle and abstract review were conducted on 1,371 articles. The full-text review was conducted on 82 articles. Data were extracted from 42 articles that met our review criteria. Most of the studies originated from the United States and Spain. Several medical conditions were considered. The use of digital tools and technologies was rarely reported. In particular, innovative approaches such as wearables or sensor technologies were rarely used. The current landscape of hospital@home models of care simply delivers hospital care in the patient's home. Tools or approaches from taking a participatory health informatics design approach involving a range of stakeholders (such as patients and their caregivers) were not reported in the literature reviewed. In addition, emerging technologies supporting mobile health applications, wearable technologies, and remote monitoring were rarely discussed.ConclusionThere are multiple benefits and opportunities associated with hospital@home implementations. There are also threats and weaknesses associated with the use of this model of care. Some weaknesses could be addressed by using digital health and wearable technologies to support patient monitoring and treatment at home. Employing a participatory health informatics approach to design and implementation could help to ensure the acceptance of such care models.

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“…Estudios seleccionados para lectura completa y evaluación de disponibilidad (26) Estudios excluidos tras la lectura de los textos completos (12) Estudios incluidos en la revisión ( (19) Estados Unidos…”

Section: Medline/pubmedunclassified

Cuidados de enfermagem às pessoas submetidos à cirurgia bariátrica: revisão integrativa

Derenzo,

Fernandes,

Costa

et al. 2023

Enf Global

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Objective: To identify from the scientific literature the Nursing care provided to people with obesity undergoing bariatric surgery.Method: Integrative literature review, searches were carried out from July to August/2021 in four databases: MEDLINE, LILACS, BDENF and EMBASE. The research question was delimited through the PICo strategy, considering P – Patients with obesity; I – Nursing care; Co – Obese patients undergoing bariatric surgery. The following question was elaborated: “What are the main Nursing care in patients with obesity who underwent bariatric surgery?”. Inclusion criteria primary articles that met the guiding question; available in full; during the period from 2016 to 2021; Portuguese, English and Spanish languages. Exclusion criteria gray literature, studies that did not respond to the guiding question. Search results were analyzed and interpreted.Results: 14 articles were included in the research synthesis. Analysis of the results showed that the Nursing care provided to people undergoing bariatric surgery was identified in the preoperative period: health education regarding the surgical procedure and possible complications; and in the postoperative period: guidelines for relieving anxiety. In the intraoperative period, care procedures were not mentioned.Conclusion: Considering, therefore, the presentation of results, the findings demonstrate the unequivocal need for and importance of incorporating new technologies in Nursing care; promote the training of skills and abilities of team members, in addition to carrying out new research that allows expanding the performance of the Nursing team in the care of patients undergoing bariatric surgery. Objetivo: Identificar a partir de la literatura científica los cuidados de Enfermería brindados a personas con obesidad sometidas a cirugía bariátrica.Método: Revisión integrativa de la literatura, se realizaron búsquedas de julio a agosto/2021 en cuatro bases de datos: MEDLINE, LILACS, BDENF y EMBASE. La pregunta de investigación fue delimitada a través de la estrategia PICo, considerando: P – Pacientes con obesidad; I - Atención de Enfermería; Co – Pacientes obesos sometidos a cirugía bariátrica. Se elaboró la siguiente pregunta: “¿Cuáles son los principales cuidados de Enfermería en pacientes con obesidad sometidos a cirugía bariátrica?”. Criterios de inclusión artículos primarios que cumplieron con la pregunta orientadora; disponible en su totalidad; durante el período de 2016 a 2021; Idiomas portugués, inglés y español. Criterios de exclusión literatura gris, estudios que no respondieron a la pregunta orientadora. Los resultados de la búsqueda fueron analizados e interpretados.Resultados: 14 artículos fueron incluidos en la síntesis de la investigación. El análisis de los resultados mostró que los cuidados de Enfermería prestados a las personas sometidas a cirugía bariátrica fueron identificados en el período preoperatorio: educación en salud sobre el procedimiento quirúrgico y posibles complicaciones; y en el postoperatorio: pautas para aliviar la ansiedad. En el período intraoperatorio no se mencionaron los procedimientos de atención.Conclusión: Considerando, por lo tanto, la presentación de resultados, los hallazgos demuestran la inequívoca necesidad e importancia de incorporar nuevas tecnologías en el cuidado de Enfermería; promover la formación de habilidades y destrezas de los integrantes del equipo, además de realizar nuevas investigaciones que permitan ampliar la actuación del equipo de Enfermería en el cuidado de los pacientes sometidos a cirugía bariátrica. Objetivo: Identificar a partir da literatura científica os cuidados de Enfermagem prestados as pessoas com obesidade submetidas à cirurgia bariátrica. Método: Revisão integrativa da literatura, buscas foram realizadas em julho a agosto/2021 em quatro bases de dados: MEDLINE, LILACS, BDENF e EMBASE. Delimitou-se a questão de pesquisa por meio da estratégia PICo, considerada: P – Pacientes com obesidade; I – Cuidados de Enfermagem; Co – Obesos submetidos à cirurgia bariátrica. Elaborou-se a seguinte questão: “Quais os principais cuidados de Enfermagem em pacientes com obesidade que foram submetidos à cirurgia bariátrica?”. Critérios de inclusão artigos primários que atenderam a questão norteadora; disponíveis na íntegra; durante o período de 2016 a 2021; idiomas português, inglês e espanhol. Critérios de exclusão literaturas cinzentas, estudos que não respondessem à questão norteadora. Os resultados das buscas foram analisados e interpretados.Resultados: Foram incluídos 14 artigos na síntese da pesquisa. Análise dos resultados permitiu evidenciar que os cuidados de Enfermagem prestados às pessoas submetidas à cirurgia bariátrica foram identificados nos períodos pré-operatório: educação em saúde quanto ao procedimento cirúrgico e possíveis complicações; e no pós-operatório: orientações para aliviar ansiedade. No período intraoperatório, não foram citados quais cuidados são realizados. Conclusão: Considerando, portanto, a exposição dos resultados, os achados demonstram a inequívoca necessidade e a importância da incorporação de novas tecnologias nos cuidados de Enfermagem; promover a capacitação das competências e habilidades dos integrantes da equipe, além da realização de novas pesquisas que permitam ampliar a atuação da equipe de Enfermagem no atendimento a pacientes submetidos à cirurgia bariátrica.

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Telemonitoring and home hospitalization in patients with chronic obstructive pulmonary disease: study TELEPOC

Abstract: Telemonitoring of patients with COPD combined with home hospitalization may allow for a reduction in healthcare costs, although its usefulness in preventing exacerbations is still unclear.

Cited by 20 publications

References 24 publications

Performance of an eHealth (NOMHAD) System Comprising Telemonitoring, Telenotification, and Telecoaching for Patients With Multimorbidity: Proof-of-Concept Study

Performance of an eHealth (NOMHAD) System Comprising Telemonitoring, Telenotification, and Telecoaching for Patients With Multimorbidity: Proof-of-Concept Study

Digital health as an enabler for hospital@home: A rising trend or just a vision?

Cuidados de enfermagem às pessoas submetidos à cirurgia bariátrica: revisão integrativa

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