The first remote monitoring experience in South Korea: results of a remote-care study.
Ontology highlight
ABSTRACT:
SUBMITTER: Hwang Y
PROVIDER: S-EPMC10254071 | biostudies-literature | 2023 Jun
REPOSITORIES: biostudies-literature
Publications
The first remote monitoring experience in South Korea: results of a remote-care study.
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 20230601 6
Similar Datasets
Project description:PurposeRemote monitoring of cardiac devices reduces unnecessary outpatient visits and increases patient satisfaction. We aimed to evaluate remote monitoring in terms of patient satisfaction, economic efficiency, and safety.Patients and methodsThis was a single university hospital survey. The time/medical cost efficacy and satisfaction index were evaluated using a questionnaire to investigate patient satisfaction before and after remote monitoring in patients using Biotronik implantable cardiac devices. The questionnaire was adopted and modified from Hwang's 2020 Survey on Telehealth Patient Experience.ResultsRemote monitoring was associated with a decrease in total outpatient visits. Of 1270 remote monitoring-related alerts clinicians received during the study period, more than 95% were from patients with pacemakers. Still, the severity of alerts was higher for implantable cardioverter defibrillators and cardiac resynchronization therapy with defibrillators. The post-RM survey results demonstrated that patients were generally satisfied with RM, perceived it as cost-effective, and found that RM facilitated health management without disrupting their daily routines.ConclusionThe study participants were satisfied with their first remote monitoring experience and reported having time- and cost-savings by using remote monitoring. Remote monitoring-related alerts from high-voltage devices were more severe and required medical intervention.
| S-EPMC10522456 | biostudies-literature
Project description:Background/aimsStudies showed that remote device monitoring reduced unnecessary outpatient visits and increased patient satisfaction. As there was no local research on remote monitoring (RM) in Korea, there was a lack of evidence for policy or insurance standards due to the lack of domestic data despite high demand by domestic arrhythmia experts. To establish the basis for patient satisfaction, economic efficiency, and safety of wireless monitoring, a survey-based study was planned.MethodsThis was a single-university hospital survey. The satisfaction index was evaluated using a questionnaire to investigate patient satisfaction in outpatient clinics, economic efficiency (measured as home-to-clinic time, waiting time, and actual clinic time), and demand for RM in patients with implantable cardiac devices. The questionnaire was adopted and modified from the Survey on Telehealth Patient Experience by Bas-Villalobos, 2006 (modified Korean version 2.0 by You Mi Hwang, 2020).ResultsSurveys were answered by 171 patients. The mean age of these patients was 71.2 ± 12.4 years. Based on the survey, home to clinic time was usually less than one h, mean waiting time in the hospital until clinic time ranged 42.6 ± 24.5 minutes, and mean clinic time ranged 3.1 ± 1.7 minutes. Based on the survey, patients favored RM over hospital visits with cardiac implantable electronic device follow-up mainly because of long travel times from home to clinic.ConclusionBased on the survey results, there is a clear need for RM in patients who have cardiac implantable electronic devices.
| S-EPMC9276406 | biostudies-literature
Project description:ObjectivesCurrent antenatal care largely relies on widely spaced appointments, hence only a fraction of the pregnancy period is subject to monitoring. Continuous monitoring of physiological parameters could represent a paradigm shift in obstetric care. Here, we analyse the data from daily home monitoring in pregnancy and consider the implications of this approach for tracking pregnancy health.MethodsProspective feasibility study of continuous home monitoring of blood pressure, weight, heart rate, sleep and activity patterns from the first trimester to 6 weeks postpartum.ResultsFourteen out of 24 women completed the study (58%). Compared to early pregnancy [week 13, median heart rate (HR) 72/min, interquartile range (IQR) 12.8], heart rate increased by week 35 (HR 78/min, IQR 16.6; P = 0.041) and fell postpartum (HR 66/min, IQR 11.5, P = 0.021). Both systolic and diastolic blood pressure were lower at mid-gestation (week 20: SBP 103 mmHg, IQR 6.6; DPB 63 mmHg, IQR 5.3 P = 0.005 and P = 0.045, respectively) compared to early pregnancy (week 13, SBP 107 mmHg, IQR 12.4; DPB 67 mmHg, IQR 7.1). Weight increased during pregnancy between each time period analyzed, starting from week 15. Smartwatch recordings indicated that activity increased in the prepartum period, while deep sleep declined as pregnancy progressed.ConclusionHome monitoring tracks individual physiological responses to pregnancy in high resolution that routine clinic visits cannot. Changes in the study protocol suggested by the study participants may improve compliance for future studies, which was particularly low in the postpartum period. Future work will investigate whether distinct adaptative patterns predate obstetric complications, or can predict long-term maternal cardiovascular health.
| S-EPMC9553246 | biostudies-literature
Project description:ContextRemote patient monitoring (RPM) for diabetes and hypertension may reduce barriers to patient care, leading to improved disease control and decreased morbidity and mortality.ProgramWe describe the implementation of a community-academic partnership to improve diabetes and hypertension control for underserved populations using RPM.ImplementationIn 2014, our academic medical center (AMC) began working with community health centers (CHCs) to implement a centrally monitored RPM program for patients with diabetes. AMC nurses recruited, trained, and supported community partners through regular communication. Community sites were responsible for enrollment, follow-up visits, and all treatment adjustments.EvaluationMore than 1350 patients have been enrolled across 19 counties and 16 predominantly rural CHCs. The majority of patients reported low annual household income and African American or Hispanic background. It took about 6 to 9 months of planning at each CHC prior to first enrolled patient. More than 30% of patients utilizing the newer device continued to transmit glucose readings regularly at week 52 of enrollment. Hemoglobin A 1c data reporting was completed for more than 90% of patients at 6 and 12 months postenrollment.DiscussionPartnering of our AMC with CHCs enabled dissemination of an effective, inexpensive tool that engaged underserved populations in rural South Carolina and improved chronic disease management. We supported implementation of clinically effective diabetes RPM programs at several CHCs, reaching a large number of historically underserved and underresourced rural CHC patients with diabetes. We summarize key steps to achieving a successful, collaborative RPM program through AMC-CHC partnerships.
| S-EPMC10198796 | biostudies-literature
Project description:BackgroundThe prevalence of obesity is increasing in South Korea. We aimed to identify the perceptions, attitudes, behaviors, and barriers to effective obesity care in South Korea.MethodsThe Awareness, Care, and Treatment In Obesity maNagement-an International Observation (ACTION-IO) study was a cross-sectional survey conducted in 11 countries. Respondents were people with obesity (PwO; body mass index ≥25 kg/m2 in South Korea from self-reported height/weight) and healthcare professionals (HCPs) primarily involved in direct care with PwO.ResultsThe survey was completed by 1,500 PwO and 200 HCPs in South Korea. PwO (78%) and HCPs (81%) agreed that obesity is a chronic disease, but more PwO (84%) believed that obesity has an extreme impact on their overall health compared with HCPs (65%). Most PwO felt completely responsible for their own weight loss (81%), and 78% reported at least one serious weight loss attempt in the past. In contrast, HCPs reported that, on average, only 35% of their patients with obesity had made a serious attempt at losing weight. Only 31% of PwO had discussed weight with their HCP in the past 5 years; of those, 78% appreciated that HCPs initiated these conversations. Short appointment times restricted weight loss discussions for 70% of HCPs, and 29% of HCPs expressed complete comfort with such conversations.ConclusionSouth Korean PwO are motivated to lose weight and have expressed interest in HCPs being more active in their weight management. Further nationwide efforts may be required to lower the barriers to education about obesity and effective weight loss discussion and management.
| S-EPMC7338493 | biostudies-literature
Project description:BackgroundAround 50% of hospital readmissions due to heart failure are preventable, with lack of adherence to prescribed self-care as a driving factor. Remote tracking and reminders issued by mobile health devices could help to promote self-care, which could potentially reduce these readmissions.ObjectiveWe sought to investigate two factors: (1) feasibility of enrolling heart failure patients in a remote monitoring regimen that uses wireless sensors and patient-reported outcome measures; and (2) their adherence to using the study devices and completing patient-reported outcome measures.MethodsTwenty heart failure patients participated in piloting a remote monitoring regimen. Data collection included: (1) physical activity using wrist-worn activity trackers; (2) body weight using bathroom scales; (3) medication adherence using smart pill bottles; and (4) patient -reported outcomes using patient-reported outcome measures.ResultsWe evaluated 150 hospitalized heart failure patients and enrolled 20 individuals. Two factors contributed to 50% (65/130) being excluded from the study: smartphone ownership and patient discharge. Over the course of the study, 60.0% of the subjects wore the activity tracker for at least 70% of the hours, and 45.0% used the scale for more than 70% of the days. The pill bottle was used less than 10% of the days by 55.0% of the subjects.ConclusionsOur method of recruiting heart failure patients prior to hospital discharge may not be feasible as the enrollment rate was low. Once enrolled, the majority of subjects maintained a high adherence to wearing the activity tracker but low adherence to using the pill bottle and completing the follow-up surveys. Scale usage was fair, but it received positive reviews from most subjects. Given the observed usage and feedback, we suggest mobile health-driven interventions consider including an activity tracker and bathroom scale. We also recommend administering a shorter survey more regularly and through an easier interface.
| S-EPMC7676713 | biostudies-literature
Project description:we analyzed BM aspirates in reactive BMs, pre-PMFs, overt PMFs, and non-PMF MPNs by single-cell RNA sequencing (scRNA-seq), identifying cell types , including hematopoietic stem and progenitor cell (HSPC) and MK.
2025-01-22 | GSE254423 | GEO
Project description:BackgroundOut-of-office blood pressure (BP) measurements contribute valuable information for guiding clinical management of hypertension. Measurements from home devices can be directly transmitted to patients' electronic health record for use in remote monitoring programs.ObjectiveThis study aimed to compare in primary care practice care coordinator-assisted implementation of remote patient monitoring (RPM) for hypertension to RPM implementation alone and to usual care.MethodsThis was a pragmatic observational cohort study. Patients aged 65 to 85 years with Medicare insurance from two populations were included: those with uncontrolled hypertension and a general hypertension group seeing primary care physicians (PCPs) within one health system. Exposures were clinic-level availability of RPM plus care coordination, RPM alone, or usual care. At two clinics (13 PCPs), nurse care coordinators with PCP approval offered RPM to patients with uncontrolled office BP and assisted with initiation. At two clinics (39 PCPs), RPM was at PCPs' discretion. Twenty clinics continued usual care. Main measures were controlling high BP (<140/90 mm Hg), last office systolic blood pressure (SBP), and proportion with antihypertensive medication intensification.ResultsAmong the Medicare cohorts with uncontrolled hypertension, 16.7% (39/234) of patients from the care coordination clinics were prescribed RPM versus <1% (4/600) at noncare coordination sites. RPM-enrolled care coordination group patients had higher baseline SBP than the noncare coordination group (148.8 vs. 140.0 mm Hg). After 6 months, in the uncontrolled hypertension cohorts the prevalences of controlling high BP were 32.5% (RPM with care coordination), 30.7 % (RPM alone), and 27.1% (usual care); multivariable adjusted odds ratios (95% confidence interval) were 1.63 (1.12-2.39; p = 0.011) and 1.29 (0.98-1.69; p = 0.068) compared with usual care, respectively.ConclusionCare coordination facilitated RPM enrollment among poorly controlled hypertension patients and may improve hypertension control in primary care among Medicare patients.
| S-EPMC10232212 | biostudies-literature
Project description:BackgroundRemote monitoring systems have the potential to measure symptoms and treatment effects in people with Parkinson's disease (PwP) in the home environment. However, information about user experience and long-term compliance of such systems in a large group of PwP with relatively severe PD symptoms is lacking.ObjectiveThe aim was to gain insight into user experience and long-term compliance of a smartwatch (to be worn 24/7) and an online dashboard to report falls and receive feedback of data.MethodsWe analyzed the data of the "Bringing Parkinson Care Back Home" study, a 1-year observational cohort study in 200 PwP with a fall history. User experience, compliance, and reasons for noncompliance were described. Multiple Cox regression models were used to identify determinants of 1-year compliance.ResultsWe included 200 PwP (mean age: 69 years, 37% women), of whom 116 (58%) completed the 1-year study. The main reasons for dropping out of the study were technical problems (61 of 118 reasons). Median wear time of the smartwatch was 17.5 h/day. The online dashboard was used by 77% of participants to report falls. Smartphone possession, shorter disease duration, more severe motor symptoms, and less-severe freezing and balance problems, but not age and gender, were associated with a higher likelihood of 1-year compliance.ConclusionsThe 1-year compliance with this specific smartwatch was moderate, and the user experience was generally good, except battery life and data transfer. Future studies can build on these findings by incorporating a smartwatch that is less prone to technical issues.
| S-EPMC11489606 | biostudies-literature
Project description:BackgroundRemote monitoring (RM) in patients with advanced heart failure and cardiac resynchronization therapy defibrillators (CRT-D) may reduce delays in clinical decisions by transmitting automatic alerts. However, this strategy has never been tested specifically in this patient population, with alerts for lung fluid overload, and in a European setting.ObjectiveThe main objective of Phase 1 (presented here) is to evaluate if RM strategy is able to reduce time from device-detected events to clinical decisions.MethodsIn this multicenter randomized controlled trial, patients with moderate to severe heart failure implanted with CRT-D devices were randomized to a Remote group (with remote follow-up and wireless automatic alerts) or to a Control group (with standard follow-up without alerts). The primary endpoint of Phase 1 was the delay between an alert event and clinical decisions related to the event in the first 154 enrolled patients followed for 1 year.ResultsThe median delay from device-detected events to clinical decisions was considerably shorter in the Remote group compared to the Control group: 2 (25(th)-75(th) percentile, 1-4) days vs 29 (25(th)-75(th) percentile, 3-51) days respectively, P=.004. In-hospital visits were reduced in the Remote group (2.0 visits/patient/year vs 3.2 visits/patient/year in the Control group, 37.5% relative reduction, P<.001). Automatic alerts were successfully transmitted in 93% of events occurring outside the hospital in the Remote group. The annual rate of all-cause hospitalizations per patient did not differ between the two groups (P=.65).ConclusionsRM in CRT-D patients with advanced heart failure allows physicians to promptly react to clinically relevant automatic alerts and significantly reduces the burden of in-hospital visits.Trial registrationClinicaltrials.gov NCT00885677; http://clinicaltrials.gov/show/NCT00885677 (Archived by WebCite at http://www.webcitation.org/6IkcCJ7NF).
| S-EPMC3758044 | biostudies-literature