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Remote patient monitoring

Andreas K Triantafyllidis, Vassilis G Koutkias, Ioanna Chouvarda, Ilia Adami, Angelina Kouroubali, Nicos Maglaveras
Sensor-based health systems can often become difficult to use, extend and sustain. The authors propose a framework for designing sensor-based health monitoring systems aiming to provide extensible and usable monitoring services in the scope of pervasive patient care. The authors' approach relies on a distributed system for monitoring the patient health status anytime-anywhere and detecting potential health complications, for which healthcare professionals and patients are notified accordingly. Portable or wearable sensing devices measure the patient's physiological parameters, a smart mobile device collects and analyses the sensor data, a Medical Center system receives notifications on the detected health condition, and a Health Professional Platform is used by formal caregivers in order to review the patient condition and configure monitoring schemas...
September 2016: Healthcare Technology Letters
Erik Skobel, Christian Knackstedt, Alvaro Martinez-Romero, Dario Salvi, Cecilia Vera-Munoz, Andreas Napp, Jean Luprano, Ramon Bover, Sigrid Glöggler, Birna Bjarnason-Wehrens, Nikolaus Marx, Alan Rigby, John Cleland
Low adherence to cardiac rehabilitation (CR) might be improved by remote monitoring systems that can be used to motivate and supervise patients and tailor CR safely and effectively to their needs. The main objective of this study was to evaluate the feasibility of a smartphone-guided training system (GEX) and whether it could improve exercise capacity compared to CR delivered by conventional methods for patients with coronary artery disease (CAD). A prospective, randomized, international, multi-center study comparing CR delivered by conventional means (CG) or by remote monitoring (IG) using a new training steering/feedback tool (GEx System)...
October 11, 2016: Heart and Vessels
Daniel B Kramer, Paul W Jones, Tyson Rogers, Susan L Mitchell, Matthew R Reynolds
AIMS: Cardiac resynchronization therapy with implantable defibrillator backup (CRT-D) improves outcomes, but predictors and markers of response remain limited. Physical activity information collected by CRT devices may provide insights to CRT response and the relationship between activity changes and survival. METHODS: Patients entered into the LATITUDE remote monitoring system from 2008 to 2012 after receipt of a new CRT-D were eligible. Mean daily activity was calculated from LATITUDE uploads at baseline (first 3-10 days following implant) and 6 months (180-210 days)...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Liselotte C R Hensen, Victoria Delgado, Suzanne E van Wijngaarden, Melissa Leung, Mihaly K de Bie, Maurits S Buiten, Martin J Schalij, Jos J Van de Kerkhof, Ton J Rabelink, Joris I Rotmans, J Wouter Jukema, Jeroen J Bax
BACKGROUND: The prevalence of atrial fibrillation (AF) in end-stage renal disease (ESRD) patients is relatively high. The present study evaluated the association between left atrial (LA) remodelling, including an increased size and myocardial fibrosis, and slow LA conduction and the occurrence of AF. METHODS: In 171 ESRD patients enrolled in the Implantable Cardioverter Defibrillators in Dialysis patients (ICD2) trial, the LA dimensions, LA conduction delay [as reflected by the time difference between P-wave onset on surface electrocardiogram and A'-wave on tissue Doppler imaging (PA-TDI)] and LA function were compared between patients who exhibited AF versus patients without AF...
September 29, 2016: Nephrology, Dialysis, Transplantation
D Lanssens, A Van Moerebeke, A van den Hoogen, N Geusens, L Grieten, W Gyselaers
BACKGROUND: Gestational hypertensive disorders (GHD) are major contributors to maternal mortality worldwide. In Ziekenhuis Oost- Limburg (Genk, Belgium), a remote monitoring (RM) program for pregnant women at risk for developing GHD was initiated in January 2015 to evaluate the relevance of a RM program. RM is a relatively new approach that broadly can be defined as the application of telecommunication technologies in interchanging medical data, information and services between healthcare providers and patients...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Gregory Y H Lip, Albert L Waldo, John Ip, David T Martin, Malcolm M Bersohn, Wassim K Choucair, Joseph G Akar, Mark Wathen, Jonathan L Halperin
Implanted cardiac arrhythmia devices can detect atrial tachyarrhythmias (atrial high-rate episodes [AHREs]) that are considered to correlate with atrial fibrillation and risk of stroke. In the IMPACT trial, oral anticoagulation was initiated when AHREs were detected by implanted cardioverter-defibrillators and withdrawn when they abated, according to a protocol accounting both for AHRE duration as detected by remote device monitoring and stroke risk assessment. In this analysis, we ascertained determinants of time in therapeutic range (TTR) among protocol-determined vitamin K antagonist-treated patients during the trial...
August 31, 2016: American Journal of Cardiology
Emanuela Marcelli, Alessandro Capucci, Gabriele Minardi, Laura Cercenelli
This paper describes the conceptual design and the first prototype implementation of the Multi-Sense CardioPatch, a wearable multi-sensor patch for remote heart monitoring aimed at providing a more detailed and comprehensive heart status diagnostics. The system integrates multiple sensors in a single patch for detection of both electrical (electrocardiogram, ECG) and mechanical (Heart Sounds, HS) cardiac activity, in addition to physical activity (PA). The prototypal system also comprises a microcontroller board with a radio communication unit and it is powered by a Li-Ion rechargeable battery...
September 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Palmira Bernocchi, Simonetta Scalvini, Tiziana Galli, Mara Paneroni, Doriana Baratti, Ottavia Turla, Maria Teresa La Rovere, Maurizio Volterrani, Michele Vitacca
BACKGROUND: Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) frequently coexist, significantly reducing patients' quality of life and increasing morbidity and mortality. For either single disease, a multidisciplinary disease-management approach supported by telecommunication technologies offers the best outcome in terms of prolonged survival and reduced hospital readmissions. However, no data exist in patients with combined COPD/CHF. We planned a randomized controlled trial to investigate the feasibility and efficacy of an integrated, home-based, medical/nursing intervention plus a rehabilitation program versus conventional care in patients with coexisting COPD/CHF...
2016: Trials
Daniel Peretz, Antonia Arnaert, Norma Ponzoni
INTRODUCTION: Remote patient monitoring (RPM) in conjunction with home nursing visits is becoming increasingly popular for the follow-up of patients with chronic conditions and evidence exists that it improves patients' health outcomes. Current cost data is reported inconsistently and often gathered from studies of poor methodological quality, making it difficult for decision-makers who consider implementing this service in their organizations. This study reviewed the cost of RPM programmes targeting elderly patients with chronic conditions...
September 19, 2016: Journal of Telemedicine and Telecare
Yutaka Imai
It has been confirmed that clinical significance of home blood pressure measurements (HBPM) is higher than clinic BP measurements and ambulatory BP monitoring. However, several drawbacks of HBPM have also been mentioned, e.g. selection and reporting biases, difficulties of calculation of multiple measurements, difficulties of onsite judgement of numerous recordings, etc. Recent devices for HBPM incorporate memory function. This function can overcome such drawbacks of HBPM. These memorized data can transmit, storage, retrieve, be arithmetic and control, be judged based on algorithm and be got feedback...
September 2016: Journal of Hypertension
Jing Zhang, Lei Sun, Yu Liu, Hongyi Wang, Ningling Sun, Jia Yu, Yao He, Sijin Yan, Puhong Zhang
OBJECTIVE: To evaluate the feasibility and acceptability of a mobile device based electronical data capture (mEDC) system applied in one randomized clinical trial (RCT). DESIGN AND METHOD: The mEDC, an android smartphone-based application, was developed to support real-time data capture, project management and quality control in a multicenter randomized double-blinded parallel controlled pharmaceutical trial. Four user interfaces are shown in Figure 1. The RCT is to evaluate the efficacy of telmisartan (40mg) and hydrochlorothiazide (25mg) monotherapy in high sodium intake patients with mild to moderate hypertension in 14 hospitals, including one baseline survey and three follow-ups...
September 2016: Journal of Hypertension
Mohammad Wazid, Sherali Zeadally, Ashok Kumar Das, Vanga Odelu
Mobile Healthcare (mHealth) continues to improve because of significant improvements and the decreasing costs of Information Communication Technologies (ICTs). mHealth is a medical and public health practice, which is supported by mobile devices (for example, smartphones) and, patient monitoring devices (for example, various types of wearable sensors, etc.). An mHealth system enables healthcare experts and professionals to have ubiquitous access to a patient's health data along with providing any ongoing medical treatment at any time, any place, and from any device...
November 2016: Journal of Medical Systems
Kimberly-Anne Tan, Mathew D Sewell, Andrew J Clarke, Daniel Chan, Oliver M Stokes, Shahid N Khan, Michael Hutton
PURPOSE OF THE STUDY: Pacemakers are currently identified as a contraindication for the use of magnetic growth rods (MGRs). This arises from concern that magnetic fields generated by the MGR external remote controller (ERC) during lengthening procedures may induce pacemaker dysfunction. We investigated (1) whether MGR lengthening affects pacemaker function, and (2) if the magnetic field of a pacemaker affects MGR lengthening. METHODS: MGRs were tested in conjunction with an magnetic resonance imaging-compatible pacemaker, which was connected to a virtual patient under continuous cardiac monitoring...
September 15, 2016: Journal of Pediatric Orthopedics
Philip B Adamson, Greg Ginn, Stefan D Anker, Robert C Bourge, William T Abraham
AIMS: Haemodynamic-guided heart failure (HF) management using directly measured cardiac filling pressures in symptomatic patients is now recommended in the European Society of Cardiology (ESC) Heart Failure Guidelines [Class IIb(B)]. This meta-analysis evaluates all data from completed clinical trials evaluating this approach in patients with HF. METHODS AND RESULTS: All trials evaluating the impact of HF management based on haemodynamic monitoring using implantable devices were reviewed using standard search engine methods...
September 16, 2016: European Journal of Heart Failure
Yasser El Miedany, Maha El Gaafary, Sally Youssef, Sami Bahlas, Samah Almedany, Ihab Ahmed, Deborah Palmer
OBJECTIVE: To assess the use of electronic patient-reported outcome measures (ePROM) in standard clinical practice for early rheumatoid arthritis (RA) management, the ePROM ability to enhance clinical care, and how computing technology can improve the patients' adherence to therapy. METHODS: In a double-blinded randomized-controlled study, 211 patients with early RA diagnosed according to American College of Rheumatology/European League Against Rheumatism criteria completed a PROM in paper format at their first clinic visit...
September 15, 2016: Journal of Rheumatology
Bonnie J Wakefield, Mary Vaughan-Sarrazin
BACKGROUND: Remote health monitoring applications are being adopted to improve the health of chronically ill individuals. Little work has focused on the effects of these technologies on informal caregivers (CG) of patients with chronic illnesses. OBJECTIVES: To examine differences in caregiving appraisal between CG of enrolled and nonenrolled Veterans in the home telehealth (HT) program. METHODS: Cross-sectional survey methodology in 244 dyads (Veteran and CG) from 6 rural Midwestern Veterans Affairs Medical Centers...
September 15, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
E Tamayo Aguirre, A Galo-Anza, O Dorronsoro-Barandiaran, E Uranga-Saez Del Burgo, A Ostiza Irigoyen, A Garcia-Carro, I Lopez-Fernandez, N Colera, P Saez-Garbayo, I Tamayo-Uria
BACKGROUND: Self-management may be an option to monitor oral anticoagulant therapy in health systems, but before recommending it, we need to assess patients' ability to take on this task. The purpose of the study was to describe patients' ability to self-manage and associated factors. METHODS: This was a 3-year prospective quasi-experimental study with a control group. Overall, 333 patients on anticoagulant therapy from seven primary care health centres of the Basque Health Service were included in the intervention group and followed up for 6 months after the intervention, assessing their ability to self-test and self-manage...
2016: BMC Cardiovascular Disorders
Renato P Ricci, Alfredo Vicentini, Antonio D'Onofrio, Antonio Sagone, Giovanni Rovaris, Luigi Padeletti, Loredana Morichelli, Antonio Fusco, Stefano De Vivo, Leonida Lombardi, Alessandra Denaro, Annalisa Pollastrelli, Irene Colangelo, Massimo Santini
BACKGROUND: Remote monitoring (RM) of cardiac implantable electronic devices has been demonstrated to improve outpatient clinic workflow and patient management. However, few data are available on the socioeconomic impact of RM. OBJECTIVE: The aim of this study was to assess the costs and benefits of RM compared with standard care (SC). METHODS: We used 12-month patient data from the Health Economics Evaluation Registry for Remote Follow-up (TARIFF) study (N = 209; RM: n = 102; SC: n = 107)...
September 8, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Shivan J Mehta, Andrea B Troxel, Noora Marcus, Christina Jameson, Devon Taylor, David A Asch, Kevin G Volpp
No abstract text is available yet for this article.
September 7, 2016: JAMA Cardiology
E H Coulter, A N McLean, J P Hasler, D B Allan, A McFadyen, L Paul
STUDY DESIGN: A pilot randomised controlled trial. OBJECTIVES: The aims of this study were to evaluate the effectiveness and participant satisfaction of web-based physiotherapy in people with spinal cord injury (SCI). SETTING: Community patients of a national spinal injury unit in a university teaching hospital, Scotland, UK. METHODS: Twenty-four participants were recruited and randomised to receive 8 weeks of web-based physiotherapy (intervention), twice per week, or usual care (control)...
September 6, 2016: Spinal Cord
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