Telemedicine in patients with peripheral arterial disease: is it worth the effort?

Haveman, Marjolein E; Kleiss, Simone F.; Kirsten, F.; Vos, Cornelis G.; Ünlü, Çağdaş; Schuurmann, Richte C. L.; Bokkers, Reinoud P H; Hermens, Hermie; Vries, J.P.P.M. de

doi:10.1080/17434440.2019.1649595

Cited by 33 publications

(20 citation statements)

References 34 publications

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“…Despite the short intervention duration, a clinically relevant improvement was found in the WIQ distance score [ 41 ]. As this study was designed to primarily evaluate patients’ satisfaction and acceptance, our results complement contemporary pilot studies in the field of eHealth solutions in patients with IC [ 20 , 42 - 45 ] .…”

Section: Discussionmentioning

confidence: 76%

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Satisfaction and Acceptability of Telemonitored Home-Based Exercise in Patients With Intermittent Claudication: Pragmatic Observational Pilot Study

Cornelis¹,

Buys²,

Dewit³

et al. 2021

JMIR Rehabil Assist Technol

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Background Current guidelines recommend supervised exercise training (SET) as a first-line treatment in patients with intermittent claudication (IC). SET has been shown to be more effective than home-based exercise therapy (HBET). However, the lack of available SET programs hampers broad SET implementation in clinical practice. Objective The aim of this study is to assess patient satisfaction and acceptability of a structured HBET program using wearable technology and elastic band resistance exercises. Methods A total of 20 patients with IC (Rutherford 1-3) with internet access and currently not engaged in structured exercise training were recruited in a pragmatic observational pilot study. Participants were instructed to complete 3 walking sessions and 2 elastic band resistance exercise sessions per week in their home environment during a 4-week period. Patient satisfaction and acceptability were assessed using a 5-point Likert scale questionnaire (1-2=very unsatisfied, 3=neutral, and 4-5=very satisfied) evaluating the materials and intervention content. Secondary outcomes were evaluated at baseline and at completion of the 4-week intervention and included maximal walking distance (MWD) and pain-free walking distance (PFWD), physical fitness, and patient-reported outcomes on quality of life, walking capacity, levels of kinesiophobia, and self-efficacy. Statistically significant changes were tested using paired t tests or Wilcoxon signed-rank tests. Results All patients (15 men, 5 women; mean age 64.6, SD 10.6 years; range 41-81 years) completed the 4-week intervention and were highly satisfied with the program (mean overall score 4.5, SD 0.5). Patients’ questionnaire responses documented willingness to recommend the exercise program to other patients (mean 4.5, SD 0.5; median 4.5) and preference for continuing the intervention (mean 4.3, SD 0.5; median 4). Furthermore, participants endorsed the use of the sports watches to track walking sessions (mean 4.25, SD 0.6; median 4), felt safe (mean 4.4, SD 0.6; median 4), and appreciated personal feedback (mean 4.55, SD 0.5; median 5) and flexibility of training (mean 4.1, SD 0.7; median 4). Resistance training was not preferred over walking training (mean 2.65, SD 0.8; median 3). In addition, PFWD (+89 m; P=.001), MWD (+58 m; P=.03), Walking Impairment Questionnaire distance score (+0.18; P=.01), activity-related scores (+0.54; P<.001), and total quality of life (+0.36; P=.009) improved following the intervention. Other patient-related outcomes, physical fitness, and physical activity remained to be statistically unaltered. Conclusions Patients with IC were satisfied and accepted technology to monitor and guide HBET, with observed short-term effectiveness regarding walking capacity and quality of life. However, elastic band resistance exercises as a part of HBET were not preferred over progressive walking. Trial Registration ClinicalTrials.gov NCT04043546; https://clinicaltrials.gov/ct2/show/NCT04043546

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Section: Discussionmentioning

confidence: 76%

“…At present, eHealth technologies offer valuable tools to elicit the full potential of HBET [ 20 ]. Currently, eHealth, referred to as telerehabilitation in cardiac rehabilitation, includes exercise supervision ( telemonitoring ), guidance of exercise ( telecoaching ), and promotion of a healthy lifestyle [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Satisfaction and Acceptability of Telemonitored Home-Based Exercise in Patients With Intermittent Claudication: Pragmatic Observational Pilot Study

Cornelis¹,

Buys²,

Dewit³

et al. 2021

JMIR Rehabil Assist Technol

View full text Add to dashboard Cite

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“…Others have emphasized that the balance between face-to-face and virtual visits is delicate [ 117 ]. Telemedicine also has potentially significant effects on the doctor–patient relationship [ 118 ].…”

Section: The Digital Divide Legal Aspects and Other Barriers And Pitmentioning

confidence: 99%

Opportunities in the cloud or pie in the sky? Current status and future perspectives of telemedicine in nephrology

Stauss

Floyd

Becker

et al. 2020

Clinical Kidney Journal

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The use of telehealth to support, enhance or substitute traditional methods of delivering healthcare is becoming increasingly common in many specialties, such as stroke care, radiology and oncology. There is reason to believe that this approach remains underutilized within nephrology, which is somewhat surprising given the fact that nephrologists have always driven technological change in developing dialysis technology. Despite the obvious benefits that telehealth may provide, robust evidence remains lacking and many of the studies are anecdotal, limited to small numbers or without conclusive proof of benefit. More worryingly, quite a few studies report unexpected obstacles, pitfalls or patient dissatisfaction. However, with increasing global threats such as climate change and infectious disease, a change in approach to delivery of healthcare is needed. The current pandemic with coronavirus disease 2019 (COVID-19) has prompted the renal community to embrace telehealth to an unprecedented extent and at speed. In that sense the pandemic has already served as a disruptor, changed clinical practice and shown immense transformative potential. Here, we provide an update on current evidence and use of telehealth within various areas of nephrology globally, including the fields of dialysis, inpatient care, virtual consultation and patient empowerment. We also provide a brief primer on the use of artificial intelligence in this context and speculate about future implications. We also highlight legal aspects and pitfalls and discuss the ‘digital divide’ as a key concept that healthcare providers need to be mindful of when providing telemedicine-based approaches. Finally, we briefly discuss the immediate use of telenephrology at the onset of the COVID-19 pandemic. We hope to provide clinical nephrologists with an overview of what is currently available, as well as a glimpse into what may be expected in the future.

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“… 9 After lower extremity revascularization for PAD, telemonitoring and telecoaching have been used ranging from a wound imaging application to remote vital sign monitoring, and telehealth-based questionnaires regarding intermittent claudication. 7 One such example is implementation of the WoundCheck application as part of a 14-day postoperative follow-up protocol. 10 This application allows patients to transmit photographs and have questions answered about their recovery process through a smartphone application.…”

Section: History Of Telemedicine In Vascular Practicesmentioning

confidence: 99%

Vascular medicine in the COVID-19 era: The Vanderbilt experience

Moran

Kim

Beckman

et al. 2020

Journal of Vascular Nursing

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Coronavirus disease of 2019 poses significant risks for patients with vascular disease. Telemedicine can help clinicians provide care for patients with vascular disease while adhering to social-distancing guidelines. In this article, we review the components of telemedicine used in the vascular medicine practice at the Vanderbilt University Medical Center. In addition, we describe inpatient and outpatient diagnosis-based algorithms to help select patients for telemedicine versus in-person evaluation.

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Telemedicine in patients with peripheral arterial disease: is it worth the effort?

Cited by 33 publications

References 34 publications

Satisfaction and Acceptability of Telemonitored Home-Based Exercise in Patients With Intermittent Claudication: Pragmatic Observational Pilot Study

Satisfaction and Acceptability of Telemonitored Home-Based Exercise in Patients With Intermittent Claudication: Pragmatic Observational Pilot Study

Opportunities in the cloud or pie in the sky? Current status and future perspectives of telemedicine in nephrology

Vascular medicine in the COVID-19 era: The Vanderbilt experience

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