Mobile Health Technologies for Continuous Monitoring of Cancer Patients in Palliative Care Aiming to Predict Health Status Deterioration: A Feasibility Study
Mobile Health Technologies for Continuous Monitoring of Cancer Patients in Palliative Care Aiming to Predict Health Status Deterioration: A Feasibility Study
复制标题
DOI：
10.1089/jpm.2019.0342
复制
发表时间：
2019-12-23
影响因子：
2.8
通讯作者：
Guckenberger, Matthias
中科院分区：
文献类型：
--
作者：
Pavic, Matea;Klaas, Vanessa;Guckenberger, Matthias
背景：姑息治疗患者出院后经常发生计划外再入院或急诊访视（EV）。需要预测和预防健康状况快速恶化的策略目的：评估使用可穿戴设备进行远程监测的可行性和预测能力设计：在单中心进行前瞻性观察可行性研究设置/受试者：包括30名癌症患者，估计预期寿命>8周至18岁，从住院转为门诊治疗。为患者提供智能手机，包括预装的“活动导航”应用程序和配备传感器的手镯。随访12周。两种设备都记录了几个特征（例如，生命体征）。每天报告一次疼痛和痛苦的视觉模拟量表（VAS），每周报告一次欧洲癌症研究和治疗组织生活质量量表-核心30（EORTC QLQ-C30）。应用统计学方法探讨传感器数据、自我报告与EV或再入院或死亡之间的关系。结果：2017年2月至2018年5月，纳入30例患者。30名参与者中有25名（83%）完成了12周的随访。平均而言，53%的学习日戴着手环，85%的学习日戴着智能手机。每日数字问卷的主观评分完成率为73%。发生了8例计划外再入院。疼痛，痛苦和QLQ-C30评分的评级与再入院无关，而静息心率，静息心率变异性，以及步骤的速度显着不同的患者和没有recommissation.Conclusions：使用可穿戴设备的姑息性癌症患者的监测是可行的。初步结果表明，移动的健康特征可能是预测计划外再入院的有前途的生物标志物。
Background: Unplanned readmissions or emergency visits (EVs) after discharge from hospital are frequent in patients in palliative care. Strategies to anticipate and prevent rapid deterioration of health are needed.Objective: Assessing feasibility and predictive ability of remote monitoring using wearables.Design: Prospective observational feasibility study in a single center.Setting/Subjects: Thirty cancer patients with an estimated life expectancy of >8 weeks to 18 years and being discharged from inpatient to outpatient care were included.Measurements: Patients were provided with a smartphone, including the preinstalled "Activity Monitoring'' application and a sensor-equipped bracelet. Follow-up was 12 weeks. Both devices recorded several features (e.g., vital signs). Visual analog scale (VAS) for pain and distress was reported once daily and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) once weekly. Statistical methods were applied to explore relationship between sensor data, self-reports, and EVs or readmissions or death.Results: Between February 2017 and May 2018, 30 patients were included. Twenty-five of 30 participants (83%) completed 12 weeks of follow-up. On average, bracelet was worn on 53% and smartphone on 85% of study days. Completion rate of daily digital questionnaires for subjective ratings was 73%. Eight unplanned hospital readmissions occurred. Ratings of pain, distress, and QLQ-C30 scores were not associated with readmission, whereas resting heart rate, resting heart rate variability, as well as speed of steps differed significantly in patients with and without readmission.Conclusions: Monitoring of palliative cancer patients using wearables is feasible. First results indicate that mobile health features might be promising biomarkers to predict unplanned readmissions.