背景:哮喘是最常见的呼吸系统疾病之一,不断增加的医疗保健负担。随着COVID-19大流行的爆发,远程患者监测(RPM)在呼吸护理领域变得越来越重要。在这项试点研究中,我们引入了一个新颖的平台,该平台使用疾病控制和预防中心指南远程监测慢性呼吸系统疾病患者,以减少住院和急诊就诊.
目的:本研究旨在了解患者和医生对新的虚拟护理解决方案(KevaTalk应用程序和Keva365平台)的参与程度及其价值,对于患者和提供者来说,使用RPM工具。我们从医生和患者的角度评估了该平台的实际使用情况,以及设备对参与和监测的影响。
方法:有中度至重度持续性哮喘病史的参与者,医院的一位肺科医生看到,包括在这项研究中。纳入标准涉及年龄≥18岁,并且可以使用具有互联网的Android或iOS移动设备。我们提供了患者问卷来评估应用程序的实用性并评估其功能。我们监测了远程肺活量测定和血氧定量数据,应用程序签入,警报,以及在本研究的时间窗口期间的升级。每天审查数据,并根据患者的症状和客观数据设置预定标准以逐步升级以供医师审查。
结果:总体而言,该飞行员包括25名患者。平均年龄为57(SD10.7)岁,大多数(n=23,92%)为女性。基线问卷,用于对应用程序进行评分,提示患者的哮喘计划的入住容易和修改容易是评级最高的2个特征.总的来说,2066签到(1550绿色,506黄色,在这3个月期间,记录了10次红色检查)和1155次肺活量测定。Further,64%(14/22)和91%(20/22)的患者被发现至少一次在其红色和黄色区域出现峰值流量,分别。在这项研究的过程中,团队记录并评估了484次警报,其中37.2%(n=180)需要向医生升级;这包括转移到医疗机构,呼吸药物的改变,或进一步的教育。
结论:在这项初步研究中,我们证明了在哮喘患者中实施新型RPM平台的可行性.我们的平台显示出较高的患者参与度和满意度,并为医生提供实时主观数据,以远程评估患者,从而有助于临床决策。升级阻止了患者恶化或发作,这导致了急诊科就诊的预防。慢性疾病的持续监测比发作性监测有好处。它可以提高生活质量,更好的结果,和巨大的医疗保健储蓄。
BACKGROUND: Asthma is one of the most common respiratory diseases, with an ever-growing health care burden. Remote patient monitoring (RPM) has gained increasing importance in the respiratory care area with the outbreak of the COVID-19 pandemic. In this pilot study, we introduced a novel platform that remotely monitors patients with chronic respiratory illnesses using Centers for Disease Control and Prevention guidelines to reduce hospitalizations and emergency department visits.
OBJECTIVE: This study aimed to understand patient and physician engagement with a new virtual care solution (KevaTalk app and Keva365 platform) and the value, for both patients and providers, of using an RPM tool. We assessed real-world use of the platform from both physician and patient perspectives and the impact of devices on engagement and monitoring.
METHODS: Participants with a history of moderate to severe persistent asthma, seen by a pulmonologist at a hospital, were included in this study. The inclusion criteria involved being aged ≥18 years and having access to an Android or iOS mobile device with internet. We provided patient questionnaires to assess the app\'s usefulness and evaluate its features. We monitored remote spirometry and oximetry data, app check-ins, alerts, and escalations during this study\'s time window. Data were reviewed daily and predetermined criteria were set to escalate for physician review based on the patient\'s symptoms and objective data.
RESULTS: Overall, 25 patients were included in this pilot. The mean age was 57 (SD 10.7) years and a majority (n=23, 92%) were female. A baseline questionnaire, which was used to rate the app, indicated that the ease of check-in and ease of modification to the patient\'s asthma plan were the 2 highest rated features. In total, 2066 check-ins (1550 green, 506 yellow, and 10 red check-ins) and 1155 spirometry sessions were recorded during this 3-month period. Further, 64% (14/22) and 91% (20/22) of patients were found to have peak flows in their red and yellow zones at least once, respectively. During the course of this study, 484 alerts were recorded and evaluated by the team, of which 37.2% (n=180) required an escalation to the physician; this included a transfer to a medical facility, change in respiratory medication, or further education.
CONCLUSIONS: In this pilot study, we demonstrated the feasibility of implementing a novel RPM platform in patients with asthma. Our platform showed high patient engagement and satisfaction and provided physicians with real-time subjective data to evaluate patients remotely that aids in clinical decision-making. The escalations prevented patients from having an exacerbation or flare up, which led to the prevention of an emergency department visit. Continuous monitoring of chronic disease has benefits over episodic monitoring. It allows for improved quality of life, better outcomes, and huge health care savings.