The feasibility of remotely monitoring physical, cognitive, and psychosocial function in individuals with stroke or chronic obstructive pulmonary disease

Abstract

Objective Clinical implementation of remote monitoring of human function requires an understanding of its feasibility. We evaluated adherence and the resources required to monitor physical, cognitive, and psychosocial function in individuals with either chronic obstructive pulmonary disease or stroke during a three-month period. Methods Seventy-three individuals agreed to wear a Fitbit to monitor physical function and to complete monthly online assessments of cognitive and psychosocial function. During a three-month period, we measured adherence to monitoring (1) physical function using average daily wear time, and (2) cognition and psychosocial function using the percentage of assessments completed. We measured the resources needed to promote adherence as (1) the number of participants requiring at least one reminder to synchronize their Fitbit, and (2) the number of reminders needed for each completed cognitive and psychosocial assessment. Results After accounting for withdrawals, the average daily wear time was 77.5 ± 19.9% of the day and did not differ significantly between months 1, 2, and 3 ( p = 0.30). To achieve this level of adherence, 64.9% of participants required at least one reminder to synchronize their device. Participants completed 61.0% of the cognitive and psychosocial assessments; the portion of assessments completed each month didnot significantly differ ( p = 0.44). Participants required 1.13 ± 0.57 reminders for each completed assessment. Results did not differ by disease diagnosis. Conclusions Remote monitoring of human function in individuals with either chronic obstructive pulmonary disease or stroke is feasible as demonstrated by high adherence. However, the number of reminders required indicates that careful consideration must be given to the resources available to obtain high adherence.

Design of trials in lacunar stroke and cerebral small vessel disease: review and experience with the LACunar Intervention Trial 2 (LACI-2)

“…Reminders were sent to participants to synchronise their devices and complete online assessments, with 65% of participants requiring at least one reminder to achieve a wear time of 77%. 59 This small study included a selective and relatively young population, questioning the feasibility of remote monitoring in older or less healthy individuals. A recent study of 82 people (mean age 80 years) with dementia, including vascular dementia, demonstrated that remote monitoring of physiological parameters was feasible with carer support but needs confirmation.…”