Use of a Bluetooth tablet-based technology to improve outcomes in lung transplantation: A pilot study

Schenkel, Felicia A.; Barr, Mark L.; McCloskey, Caroline; Possemato, Tammie; O'conner, Jeremy; Sadeghi, Roya; Bembi, Maria; Duong, Marian; Patel, Jaynita; Hackmann, Amy E.; Ganesh, Sivagini

doi:10.1111/ajt.16154

Cited by 14 publications

(22 citation statements)

References 20 publications

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“…Schenkel et al 38 used Bluetooth‐based tablet technology in their study and, using this technology, transmitted patient vital signs information and respiratory parameters to real‐time transplant coordinators to improve transplant results. The platform also enables the communication between patients and providers and includes a comprehensive tutorial library with custom video content and daily reports.…”

Section: Resultsmentioning

confidence: 99%

“…An important part of software development is quality evaluation. For example, user satisfaction is one of the evaluations that can be measured by examining the usability of the system 42 ; 37/5% of the studies did not have an application quality evaluation scale, 27 , 31 , 33 , 34 , 37 , 38 and 31/25% of the articles evaluated acceptability and usability. 7 , 28 , 29 , 30 , 40 Three studies used the PSSUQ or ASQ questionnaire for evaluation, 7 , 40 , 41 and the other studies used surveys and interviews.…”

Section: Resultsmentioning

confidence: 99%

“…Most studies demonstrated improved medication adherence 7,[28][29][30]33 and increased self-care following the use of this technology, and patient empowerment, improved adherence to medical regimen, remote monitoring, and preventing readmission are examples of benefits obtained. 31,32,35,38,41 Two studies mentioned that although m-Health applications are a promising strategy, exposure had no direct effect on outcomes, and further research is required to determine how to best use this technology. 27,36 Medication management following solid organ transplants can be complex and burdensome.…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of mobile health‐based self‐management application for posttransplant cares: A systematic review

Abasi

Yazdani

Kiani

et al. 2021

Health Science Reports

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Background and aims Patients after transplantation need medical management for the rest of their lives, and self‐management seems to lead to greater adherence to medical standards, improve early physical changes, and increase patient empowerment. The main objective of this article is to systematic review of the consideration to mobile health applications (m‐Health apps) used in transplantation. Methods A systematic search was conducted MEDLINE (through PubMed), Web of Science, Scopus, and Science Direct from inception to November 2020. The Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) statement was used in this study. Comprehensive research was carried out using a combination of keywords and MeSH terms associated with m‐Health, empowerment, self‐management, and transplantation. Two independent reviewers screened titles and abstracts, assessed full‐text articles, and extracted data from articles that met inclusion criteria. Eligible studies were original research articles that included posttransplant care and mobile phone‐based applications to support self‐management and self‐care. Also, thesis, book chapters, letters to editors, short briefs, reports, technical reports, book reviews, systematic reviews, or meta‐analysis were excluded. Results We divided all the reviewed articles into four categories, self‐management (medication adherence, adherence to medical regimen, and remote monitoring), evaluation, interaction, and interface; 37.5% of the studies were focused on lung transplantation. In 56.25% of the studies, medication adherence was considered because one of the main reasons for the rejection and graft loss is stated medication nonadherence. Also, 62.5% of the studies demonstrated that the use of m‐health improved medication adherence and self‐management in transplantation. Conclusions The use of m‐Health apps interventions to self‐management after transplantation has shown promising feasibility and acceptability, and there is modest evidence to support the efficacy of these interventions. We found that m‐Health solutions can help the patient in self‐management in many ways after transplantation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness of mobile health‐based self‐management application for posttransplant cares: A systematic review

Abasi

Yazdani

Kiani

et al. 2021

Health Science Reports

View full text Add to dashboard Cite

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“…In pediatric oncology, a systematic review of 21 digital health interventions identified mixed evidence for effectiveness, but these studies suffered from several methodological limitations. 51 A recently published pilot study 52 investigating a remote monitoring intervention in adult lung transplant recipients determined they could be engaged long term (i.e., enter monitoring data at least weekly for approximately 2 years). Survival rates did not differ between the monitored and control groups, but in a retrospective review, the intervention was associated with lower hospital readmissions and as intended, the intervention addressed avoidance behaviors in patients and/or their caregivers, decreased distress, and increased medication adherence.…”

Section: Discussionmentioning

confidence: 99%

Remote intervention engagement and outcomes in the Clinical Trials in Organ Transplantation in Children consortium multisite trial

Duncan-Park

Dunphy

Becker

et al. 2021

American Journal of Transplantation

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Remote interventions are increasingly used in transplant medicine but have rarely been rigorously evaluated. We investigated a remote intervention targeting immunosuppressant management in pediatric lung transplant recipients. Patients were recruited from a larger multisite trial if they had a Medication Level Variability Index (MLVI) ≥2.0, indicating worrisome tacrolimus level fluctuation. The manualized intervention included three weekly phone calls and regular follow-up calls. A comparison group included patients who met enrollment criteria after the subprotocol ended.Outcomes were defined before the intent-to-treat analysis. Feasibility was defined as ≥50% of participants completing the weekly calls. MLVI was compared pre-and 180 days postenrollment and between intervention and comparison groups. Of 18 eligible patients, 15 enrolled. Seven additional patients served as the comparison.Seventy-five percent of participants completed ≥3 weekly calls; average time on protocol was 257.7 days. Average intervention group MLVI was significantly lower (indicating improved blood level stability) at 180 days postenrollment (2.9 ± 1.29) compared with pre-enrollment (4.6 ± 2.10), p = .02. At 180 days, MLVI decreased by 1.6 points in the intervention group but increased by 0.6 in the comparison group DUNCAN-PARK et Al. | 3113 AJT 1 | INTRODUC TI ON Remote communications (e.g., telephone, video, or text messaging) can improve access to medical services. 1 More recently, clinicians and institutions have turned to remote communication to minimize contagion during the COVID-19 pandemic. 2Remote contacts may have particular appeal in the long-term management of transplant recipients. First, reducing exposure to pathogens is especially important in immunosuppressed individuals, 3 and indeed, transplant programs have rapidly turned to telehealth in the context of COVID-19. [4][5][6] Second, many transplant recipients travel extensively for their care, 7,8 and remote technology may reduce this burden. Third, immunosuppressant nonadherence remains the leading cause of preventable graft failure, [9][10][11][12][13][14][15] and frequent remote encounters could facilitate adherence. But, there are challenges. Remote interventions may be less effective at communicating with patients than in-person encounters, confidentiality must be maintained, and some patients may not have the means or comfort with technology to participate. 16,17 Key components of a robust evaluation of telehealth interventions include assessing predefined outcomes in prospective multisite trials. 18 Yet, despite its promise, there is a dearth of such investigations into telehealth in pediatric populations. [19][20][21]

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“…While wearable technologies have yet to be extensively used for monitoring of SOTRs, a study of 88 Australian adult CKD and kidney transplant recipients, a clinical-grade wearable device measuring peripheral body temperature with an infrared thermopile correctly identified infection in 65 patients with 80% sensitivity and 98% specificity [27]. Another study found that Bluetooth-enabled devices for at-home physiological monitoring of lung transplant recipients resulted in lower incidences of hospital readmissions [28]. The at-home monitoring consisted of daily updates of BP, HR, weight, blood glucose, SpO 2 , pulmonary function, and activity levels, which could be measured using wearable devices.…”

Section: Wearable Devicesmentioning

confidence: 99%

Early detection of SARS‐CoV‐2 and other infections in solid organ transplant recipients and household members using wearable devices

et al. 2021

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The increasing global prevalence of SARS-CoV-2 and the resulting COVID-19 disease pandemic pose significant concerns for clinical management of solid organ transplant recipients (SOTR). Wearable devices that can measure physiologic changes in biometrics including heart rate, heart rate variability, body temperature, respiratory, activity (such as steps taken per day) and sleep patterns, and blood oxygen saturation show utility for the early detection of infection before clinical presentation of symptoms. Recent algorithms developed using preliminary wearable datasets show that SARS-CoV-2 is detectable before clinical symptoms in >80% of adults. Early detection of SARS-CoV-2, influenza, and other pathogens in SOTR, and their household members, could facilitate early interventions such as self-isolation and early clinical management of relevant infection(s). Ongoing studies testing the utility of wearable devices such as smartwatches for early detection of SARS-CoV-2 and other infections in the general population are reviewed here, along with the practical challenges to implementing these processes at scale in pediatric and adult SOTR, and their household members. The resources and logistics, including transplant-specific analyses pipelines to account for confounders such as polypharmacy and comorbidities, required in studies of pediatric and adult SOTR for the robust early detection of SARS-CoV-2, and other infections are also reviewed.

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Use of a Bluetooth tablet-based technology to improve outcomes in lung transplantation: A pilot study

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri bution-NonCo mmerc ial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 14 publications

References 20 publications

Effectiveness of mobile health‐based self‐management application for posttransplant cares: A systematic review

Effectiveness of mobile health‐based self‐management application for posttransplant cares: A systematic review

Remote intervention engagement and outcomes in the Clinical Trials in Organ Transplantation in Children consortium multisite trial

Early detection of SARS‐CoV‐2 and other infections in solid organ transplant recipients and household members using wearable devices

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