Remote Patient Monitoring in the Management of Chronic Obstructive Pulmonary Disease

Chalupsky, Megan; Craddock, Krystal M; Schivo, Michael; Kühn, Bärbel

doi:10.1136/jim-2022-002430

Cited by 3 publications

(2 citation statements)

References 99 publications

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“…Physical activity is one important aspect of function targeted during rehabilitation due to its association with hospital admission (8), risk of stroke (9), development of cardiovascular diseases (10,11), and mortality (12)(13)(14). Physical activity is easily measured using wearable devices (e.g., Fitbits); however, clinical utility is limited by the time required to set up the device, download and analyze data, and synthesize, document, and discuss the results (2,5,(15)(16)(17). These barriers are exacerbated by the lack of research demonstrating the value of remote monitoring approaches (3,15,(17)(18)(19) and concerns about patient adherence (20).…”

Section: Introductionmentioning

confidence: 99%

Impact of automated data flow and reminders on adherence and resource utilization for remotely monitoring physical activity in individuals with stroke or chronic obstructive pulmonary disease

French,

Balasubramanian,

Hansel

et al. 2024

Preprint

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As rehabilitation advances into the era of digital health, remote monitoring of physical activity via wearable devices has the potential to change how we provide care. However, uncertainties about patient adherence and the significant resource requirements needed create challenges to adoption of remote monitoring into clinical care. Here we aim to determine the impact of a novel digital application to overcome these barriers. The Rehabilitation Remote Monitoring Application (RRMA) automatically extracts data about physical activity collected via a Fitbit device, screens the data for adherence, and contacts the participant if adherence is low. We compare adherence and estimate the resources required (i.e., time and financial) to perform remote monitoring of physical activity with and without the RRMA in two patient groups. Seventy-three individuals with stroke or chronic obstructive pulmonary disease completed 28 days of monitoring physical activity with the RRMA, while 62 individuals completed 28 days with the data flow processes being completed manually. Adherence (i.e., the average percentage of the day that the device was worn) was similar between groups (p=0.85). However, the RRMA saved an estimated 123.8 minutes or $50.24 per participant month when compared to manual processes. These results demonstrate that automated technologies like the RRMA can maintain patient adherence to remote monitoring of physical activity while reducing the time and financial resources needed. Applications like the RRMA can facilitate the adoption of remote monitoring in rehabilitation by reducing barriers related to adherence and resource requirements.

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Section: Introductionmentioning

confidence: 99%

Impact of automated data flow and reminders on adherence and resource utilization for remotely monitoring physical activity in individuals with stroke or chronic obstructive pulmonary disease

French,

Balasubramanian,

Hansel

et al. 2024

Preprint

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“…6 Moreover, general practitioners have cited time constraints and lack of staff training as barriers to performing ABPI assessments, 7 as reiterated in a systematic review by Cain et al 8 The LOI offers a cheaper and more straightforward alternative to ABPI. 5 Additionally, with the growing trend of patients owning pulse oximeters for selfmonitoring respiratory diseases, 9 it appears to be an easy and patient-friendly approach to clinical assessment. Despite these advantages, the LOI is not currently featured in contemporary best-practice documents or included in National Institute for Health and Care Excellence (NICE) quality standards.…”

Section: Introductionmentioning

confidence: 99%

Clinimetrics of the Lanarkshire Oximetry Index for patients with leg ulcers: A systematic review and meta‐analysis

Wynn,

Stephens,

Pradeep

et al. 2023

International Wound Journal

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Ankle Brachial Pressure Index (ABPI) measurement has long been considered the gold standard of vascular assessment for people with lower limb ulceration. Despite this, only around 15% of patients in the United Kingdom who require an ABPI measurement undergo the assessment. The Lanarkshire Oximetry Index (LOI) is a cheaper and arguably more accessible approach to vascular assessment and was initially proposed as an alternative to the ABPI in 2000. No synthesis of evidence related to the LOI has been performed since its introduction into the literature. Primary studies were sought to determine the clinimetric properties of the LOI and its level of agreement with ABPI assessments. Systematic searches of MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, BNI, ProQuest Health and Medicine, Science Direct, Google Scholar and the British Library (online search) were conducted. Reference lists of identified studies were also reviewed to identify additional studies. Three primary studies met the inclusion criteria, reporting data from 307 patients and 584 limbs assessed using both the LOI and ABPI. All three studies reported fair to moderate kappa values for interrater reliability (κ = 0.290–0.747) and statistically significant positive correlation coefficients (r = 0.37, p < 0.001 in two studies) between the LOI and ABPI. The combined data from the three studies indicated a sensitivity of 52% (41.78–62.1, 95% confidence interval [CI]) and specificity of 96.08% (93.4–97.9, 95% CI) for the LOI using the ABPI as a reference. Additional data are required to indicate the safety of the LOI in practice. Data are also required to determine if the LOI is more acceptable to clinicians compared to the ABPI and whether there are any barriers/enablers to its implementation in practice. Given the relatively low specificity of the LOI, it may be beneficial to combine measurement of the LOI with a subjective clinical risk assessment tool to improve the sensitivity of this alternative approach to vascular assessment.

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Telehealth Services

Davis

Rheuban

Harris

2023

Clinics in Chest Medicine

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Remote Patient Monitoring in the Management of Chronic Obstructive Pulmonary Disease

Cited by 3 publications

References 99 publications

Impact of automated data flow and reminders on adherence and resource utilization for remotely monitoring physical activity in individuals with stroke or chronic obstructive pulmonary disease

Impact of automated data flow and reminders on adherence and resource utilization for remotely monitoring physical activity in individuals with stroke or chronic obstructive pulmonary disease

Clinimetrics of the Lanarkshire Oximetry Index for patients with leg ulcers: A systematic review and meta‐analysis

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