Determining the acceptability and feasibility of mobile-health approaches to gather clinical information from patients at home following hospital discharge

确定移动医疗方法在出院后在家中收集患者临床信息的可接受性和可行性

• 批准号: 10052922
• 负责人: PHILIP M. POLGREEN
• 金额: $ 28.66万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10052922
• 关键词: Accident and Emergency department; Address; Antibiotics; Blood Pressure; Bluetooth; Clinic; Clinical; Clinical Data; Clinical Research; Clinics and Hospitals; Collaborations; Collection; Computer software; Custom; Data; Data Collection; Data Reporting; Devices; Environment; Feedback; Funding; Future; Generations; Goals; Health; Healthcare; Home environment; Hospitals; Interview; Iowa; Measurement; Measures; Medical; Monitor; Operative Surgical Procedures; Outcome; Outpatients; Participant; Patient Outcomes Assessments; Patients; Persons; Population; Population Heterogeneity; Research; Research Personnel; Research Project Grants; Research Subjects; Sample Size; Schedule; Site; Specialized Center; Surveys; Telephone; Testing; Text Messaging; Thermometers; Time; Translational Research; Universities; Visit; Vulnerable Populations; Washington; antimicrobial; base; design; hospital readmission; improved; informatics tool; intravenous administration; mHealth; mobile application; novel strategies; rural area; sensor; tool; web-based tool

Abstract Patients are increasingly leaving the hospital sooner and continuing therapies historically only administered in hospitals in their homes. One of the first of such therapies was the home administration of intravenous antibiotics, referred to as outpatient parenteral antimicrobial therapy (OPAT). Many patients discharged on OPAT require unplanned hospital readmissions and visits to the emergency department within the first 30 days of discharge. Because this population routinely suffers from a wide range of medical and surgical problems, it presents a unique opportunity to efficiently study a range of health outcomes in a vulnerable population. The emerging ubiquity of personal computing devices provides new opportunities to collect health-related data outside traditional clinical environments. The promise of collecting meaningful data increases if survey questions can be paired with “objective” information collected from sensors capable of collecting health-related data. To date, our CTSA hub at The University of Iowa has designed, tested and deployed custom m-health software to aggregate information from subjects using SMS, web-based tools, and mobile apps. We have also integrated information directly from sensors (step counters, blood pressure cuffs, scales, thermometers) into our custom software so that we can remotely collect objective health-related data from research subjects. In this proposal we will use our m-health platform to shift health- related measurements and data collection previously only available in hospitals into research subjects' homes. In addition, we will use our approach to measure health-related outcomes among patients discharged on OPAT. The overarching goal of our research is to develop easy-to-use informatics tools that are not disease specific. With these tools, we hope to enable the efficient collection of important clinical data from patients outside traditional research and clinical settings. First, we will assess the feasibility of using our mobile-health approach to gather clinical data from patients in their homes following discharge from the hospital on OPAT. Second, we will determine subject and researcher perspectives regarding the utility of our approach. Third, we will estimate the sample size necessary to power a study to determine the utility of remotely-collected patient-reported data for predicting hospital readmissions among patients discharged on OPAT. Completion of these aims will allow us to determine the potential for using m-health tools in a real-world setting to gather not only patient-reported outcomes, but also data from sensors to help answer a wide range of clinical research questions.

摘要 越来越多的患者更早地出院，而且从历史上看，继续治疗仅限于 在他们家中的医院接受治疗。最早的这种疗法之一是家庭疗法。 静脉注射抗生素，称为门诊非肠道抗菌药物 治疗(OPAT)。许多因OPAT出院的患者需要计划外的再次住院治疗 并在出院后的头30天内去急诊科就诊。因为这件事 人们经常遭受各种内科和外科问题的困扰，它呈现出一种 这是一个独特的机会，可以有效地研究弱势群体的一系列健康结果。 个人计算设备的出现为收集信息提供了新的机会 传统临床环境之外的健康相关数据。收藏的承诺 如果调查问题能与“客观”信息配对，有意义的数据就会增加 收集自能够收集与健康相关的数据的传感器。迄今为止，我们的CTSA中心位于 爱荷华大学设计、测试和部署了定制移动健康软件，以聚合 使用短信、基于网络的工具和移动应用程序来自受试者的信息。我们还有 直接来自传感器的集成信息(计步器、血压袖带、秤、 温度计)添加到我们的定制软件中，这样我们就可以远程收集与健康相关的客观数据 来自研究对象的数据。在这项提案中，我们将使用我们的移动健康平台来转移健康- 相关测量和数据收集以前只能在医院进行研究 受试者的家。此外，我们将使用我们的方法来衡量与健康相关的结果 在OPAT出院的患者中。 我们研究的首要目标是开发易于使用的信息学工具，而不是 特定于疾病的。通过这些工具，我们希望能够有效地收集重要的临床 来自传统研究和临床环境之外的患者的数据。首先，我们将评估 使用我们的移动医疗方法收集患者的临床数据的可行性 在OPAT出院后的家中。第二，我们将确定主体和 研究人员对我们方法的实用性的看法。第三，我们将对样本进行估计 支持一项研究以确定远程收集患者报告的效用所需的大小 OPAT出院患者再入院预测数据。 完成这些目标将使我们能够确定在 现实世界的设置，不仅收集患者报告的结果，还收集来自传感器的数据 帮助回答广泛的临床研究问题。