Clinical Study · 2020
Feasibility and Acceptability of Using a Telehealth Platform to Monitor Cardiovascular Risk Factors
A study of remote monitoring in hematopoietic cell transplantation survivors at intermediate to high risk for cardiovascular disease.
Study overview
Remote monitoring during a vulnerable point in survivorship care.
Cardiovascular disease is a leading cause of morbidity and mortality in hematopoietic cell transplantation survivors. The study evaluated whether a remote, risk-based monitoring and management program could be both feasible and acceptable for survivors at intermediate to high cardiovascular risk.
Participants used connected blood pressure, weight, pulse oximetry, and glucose monitoring over four weeks, with readings transmitted for review and predefined alerts routed for clinical triage when needed.
Key findings
What the four-week study found.
The preserved study reported strong engagement and high acceptability among the 18 participants who completed at least one requested measurement.
11 allogeneic and 7 autologous HCT survivors at intermediate to high cardiovascular risk.
Compliance with the remote monitoring schedule rose from week 1 to weeks 2 through 4.
Fifteen participants generated readings outside predetermined ranges during the study.
More than 85% agreed the study supported healthcare goals, learning, condition management, and access.
Alert resolution
73% of out-of-range readings normalized without intervention.
Clinical triage
27% of out-of-range readings necessitated triage by the study research nurse.
Abstract
Preserved study abstract
Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in hematopoietic cell transplantation (HCT) survivors. In these patients, such risk factors as hypertension, diabetes, obesity, and physical inactivity are important modifiers of CVD risk. However, the period when HCT survivors are at greatest risk of developing these risk factors, and in turn CVD, coincides with a drop in engagement in survivorship care.
We examined the feasibility and acceptability of a 4-week remote risk-based monitoring (blood pressure monitor, weight scale, pulse oximeter, glucometer) and management program in 18 (11 allogeneic and 7 autologous) HCT survivors at intermediate-high risk of CVD. The median patient age was 66 years (range, 53 to 74 years), 67% had hypertension, 22% had diabetes, 11% were obese (body mass index ≥30 kg/m2), 56% were at intermediate risk of CVD, and 44% were at high risk of CVD.
Weekly compliance with the remote monitoring schedule (≥3 readings/week using all devices) ranged from 72% in week 1 to 83% in weeks 2 to 4. Fifteen participants (83%) generated 86 alerts that were outside the predetermined range of normal; 63 of these readings (73%) normalized without intervention, and 23 (27%) necessitated triage by the study research nurse.
Nearly all participants reported that the study kept them motivated and involved in their healthcare, and >85% agreed that the study supported their healthcare goals, helped them learn and manage their health conditions, and increased their access to healthcare. These findings may set the foundation for innovative risk-based and remote interventions to reduce the burden of CVD in this growing population of patients.
Authors
Study authors and institutions
Ellen Chang, Aleksi Iukuridze, Meagan Echevarria, Jennifer Berano Teh, Dayana Chanson, Bonnie Ky, Eric J. Chow, Ryotaro Nakamura, Lanie Lindenfeld, and Saro H. Armenian.
- Children’s Hospital Los Angeles, Department of Hematology and Oncology
- City of Hope, Department of Population Sciences
- Perelman School of Medicine at the University of Pennsylvania
- Seattle Children’s Hospital, Department of Hematology and Oncology
- City of Hope, Department of Hematology and Hematopoietic Cell Transplantation
Study files
Original PDFs preserved locally
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