1. Tele-monitoring in paediatric and young home-ventilated neuromuscular patients: A multicentre case-control trial.
- Author
-
Trucco, Federica, Pedemonte, Marina, Racca, Fabrizio, Falsaperla, Raffaele, Romano, Catia, Wenzel, Anette, D'Agostino, Alessia, Pistorio, Angela, Tacchetti, Paola, Bella, Cristina, Bruno, Claudio, and Minetti, Carlo
- Subjects
- *
PATIENT monitoring , *TELEMEDICINE , *MEDICAL rehabilitation , *NEUROMUSCULAR diseases , *HOME care services - Abstract
Introduction: Tele-monitoring (TM) has proved effective in the home management of adult ventilator-dependent neuromuscular disease (NMD) patients. We aimed to evaluate a 2-year longitudinal multicentre TM trial designed for young ventilated NMD patients in terms of feasibility, home management of exacerbations and caregivers' burden.Methods: The TM trial protocol included patients' weekly scheduled overnight home-recording of SpO2, heart rate and ventilation and their transmission to each TM centre the following morning. Overnight data were reviewed by non-physicians and calls to families made to assess clinical condition. If clinical conditions (assessed by a scoring system) or overnight parameters worsened, either unscheduled transmissions or calls were activated and managed by non-physicians or medical team according to severity. Hospitalisations were compared with those of TM patients prior to TM start and with those of age-disease-severity-matched controls. Scores from the Caregiver Burden Inventory (CBI) questionnaire pre- and post-TM were compared.Results: Forty-eight patients were enrolled, 30 males, median age 16.4 years (interquartile range (IQR) 8.9-22.1), median ventilation/day 10.5 h (IQR 8-16). Exacerbations in TM patients did not differ (59 versus 53; p = 0.15) from controls. Hospitalisations were significantly reduced in TM patients when compared with those prior to TM (11 versus 24, p = 0.04) and to controls (11 versus 21, p = 0.03). Median hospitalisation length was significantly lower in TM patients than controls (6 versus 7 days, p = 0.03). Caregivers satisfaction was excellent whereas no significant changes in CBI were seen (32.5 versus 35.5, p = 0.06).Discussion: TM was effective in improving the home management of respiratory exacerbations in young ventilated NMD patients and overall well tolerated. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF