Remote Monitoring of Blood Pressure by using Wireless Devices

2021 ◽  
Author(s):  
Teofil Ursache ◽  
Gladiola Gabriela Petroiu ◽  
Cristian Rotariu
Keyword(s):  
Blood Pressure ◽  
Remote Monitoring ◽  
Wireless Devices

scholarly journals Prospects for Blood Pressure Remote Monitoring in Hypertensive Patients in the Ryazan Region

2020 ◽  
Vol 15 (6) ◽  
pp. 795-801
Author(s):  
N. V. Aksenova ◽  
A. A. Nizov ◽  
O. N. Selyavina ◽  
E. I. Suchkova ◽  
E. V. Filippov
Keyword(s):  
Blood Pressure ◽  
Remote Monitoring ◽  
Medical Professional ◽  
Automatic Data ◽  
Hardware Complex ◽  
Software And Hardware ◽  
Monitoring Center ◽  
Clinically Significant ◽  
High Level ◽  
Attending Physician

Aim. To study the effectiveness and benefits of blood pressure (BP) remote monitoring in outpatients with hypertension.Material and methods. The study included 100 patients with a verified diagnosis of hypertension, who didn’t achieve target BP pressure levels. The patients measured their BP twice a day over 6 months with facilities with automatic data transmission over GSM-channel to a remote monitoring center. BP parameters were being transmitted online to the remote monitoring center, where they were being processed and transferred to the personal account planner (created by the Web interface based on the software and hardware complex) of the attending physician and operator of the remote monitoring center. It is important that doctor received information only on clinically significant measurement results, based on which he determined the urgency of contact with the patient and the further tactics of his management.Results. No malfunctions in the work of communication facilities, technical failures in the software and hardware complex were registered over the entire period of the study. After 6 months of the monitoring it was possible to achieve target BP levels less than 135/85 mm Hg in 70% of patients. The proportion of patients with a high level of normal BP increased from 10% to 19%, while the proportion of patients with grade 1 and 2 of hypertension decreased significantly (from 33% to 7% and from 54% to 3%, respectively). At the beginning of telemedicine monitoring 3% of patients had stage 3 of hypertension, at the end of the study – 1%.Conclusion. The technology of telemedicine monitoring has shown itself as a simple, affordable and reliable way of management of outpatients with hypertension in conditions of real clinical practice. It was possible to achieve BP levels less than 135/85 mm Hg in 70% of patients by the method of remote outpatient monitoring. BP remote monitoring changed fundamentally the decision-making strategy of the patients management: it was not the patient who independently determined the need for consultation with a medical professional, but the attending physician made a decision on the method and urgency of contact with the patient on the basis of the data of objective monitoring indicators.

Remote Monitoring Technology to Improve Blood Pressure in a Rural Population

2011 ◽  
Vol 43 (Suppl 1) ◽  
pp. 548
Author(s):  
Melanie I. Stuckey ◽  
Sheree Shapiro ◽  
Kristin J. Sabourin ◽  
Claudio Munoz ◽  
Robert J. Petrella
Keyword(s):  
Blood Pressure ◽  
Remote Monitoring ◽  
Rural Population ◽  
Monitoring Technology

Abstract 18895: Utility of Remote Monitoring Using a Mobile Phone in Patients with Heart Failure: the REMOTE-HF-1 Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Marcus Stahlberg ◽  
Satish C Govind ◽  
Nicole M Orr ◽  
Aasha S Gopal ◽  
Justine S Lachmann ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Mobile Phone ◽  
Monitoring System ◽  
Primary Endpoint ◽  
Remote Monitoring ◽  
Nyha Class ◽  
Drop Out ◽  
Remote Monitoring System ◽  
Custom Made

Objective: To investigate the clinical feasibility (technical feasibility and patient-/clinician adherence) of remote telemonitoring, using a mobile phone, in an international and diverse HF population. Methods: HF patients from five centers in the USA, India and Sweden were equipped with a blood pressure apparatus, digital weight scale and a mobile phone device with custom made software for remote telemonitoring (Vitalbeat®). Patients were asked to record and transmit daily information on body weight, blood pressure and pulse rate as well as symptoms and adherence to medical therapy for 90 days. The primary endpoint, for assessment of general feasibility was defined as % of days with a combination of successful data transmission from patients and data read by clinicians. Acceptable clinical feasibility was a priori set as ≥ 66% of days meeting the primary endpoint. A survey was used to assess patients’ opinions about the remote monitoring system. Data was analyzed according to Intention to treat. Results: 46 HF patients were included (India=20, USA=13, Sweden=13; 59±16yrs; 84% male; NYHA-class 2.4±0.8) and followed for a total of 4410 days. The primary endpoint occurred in 3178 days (77%) and 34/46 patients (74%) exceeded the cut-off ≥ 66% of days meeting endpoint criteria. In the majority of patients (n=28; 61 %) the primary endpoint was met ≥ 90% of the days, and in 6 patients (13%) 66-89% of the days.Twelve patients (26%) opted to drop out of the study prematurely or were hospitalized for HF related causes. Compared to patients with acceptable clinical feasibility (≥ 66%), patients with less than acceptable feasibility (< 66%) were older (72±12 vs. 56±15 yrs, p=0.003) and more likely to be followed at a center in USA or Sweden (p=0.02 vs. Indian centers). The monitoring system was described as user friendly by 91 % of patients. Conclusion: This study shows that remote telemonitoring using a mobile phone is clinically feasible in an international and diverse heart failure population. However, monitoring was less feasible in elderly patients and depended on the geographic location. Further studies are warranted to assess whether clinical feasibility can improve with improved software/hardware design and/or patient selection.

Results of remote follow-up and monitoring in young patients with cardiac implantable electronic devices

2015 ◽  
Vol 26 (1) ◽  
pp. 53-60 ◽  
Author(s):  
Massimo S. Silvetti ◽  
Fabio A. Saputo ◽  
Rosalinda Palmieri ◽  
Silvia Placidi ◽  
Lorenzo Santucci ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Heart Defects ◽  
Electronic Devices ◽  
Young Patients ◽  
Implantable Cardioverter Defibrillators ◽  
Wireless Devices ◽  
Cardiac Implantable Electronic Devices ◽  
System Inclusion ◽  
To Receive

AbstractBackgroundRemote monitoring is increasingly used in the follow-up of patients with cardiac implantable electronic devices. Data on paediatric populations are still lacking. The aim of our study was to follow-up young patients both in-hospital and remotely to enhance device surveillance.MethodsThis is an observational registry collecting data on consecutive patients followed-up with the CareLink system. Inclusion criteria were a Medtronic device implanted and patient’s willingness to receive CareLink. Patients were stratified according to age and presence of congenital/structural heart defects (CHD).ResultsA total of 221 patients with a device – 200 pacemakers, 19 implantable cardioverter defibrillators, and two loop recorders – were enrolled (median age of 17 years, range 1–40); 58% of patients were younger than 18 years of age and 73% had CHD. During a follow-up of 12 months (range 4–18), 1361 transmissions (8.9% unscheduled) were reviewed by technicians. Time for review was 6±2 minutes (mean±standard deviation). Missed transmissions were 10.1%. Events were documented in 45% of transmissions, with 2.7% yellow alerts and 0.6% red alerts sent by wireless devices. No significant differences were found in transmission results according to age or presence of CHD. Physicians reviewed 6.3% of transmissions, 29 patients were contacted by phone, and 12 patients underwent unscheduled in-hospital visits. The event recognition with remote monitoring occurred 76 days (range 16–150) earlier than the next scheduled in-office follow-up.ConclusionsRemote follow-up/monitoring with the CareLink system is useful to enhance device surveillance in young patients. The majority of events were not clinically relevant, and the remaining led to timely management of problems.

scholarly journals Design of the Pregnancy REmote MOnitoring II study (PREMOM II): a multicenter, randomized controlled trial of remote monitoring for gestational hypertensive disorders

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Dorien Lanssens ◽  
◽  
Inge M. Thijs ◽  
Wilfried Gyselaers
Keyword(s):  
Blood Pressure ◽  
Remote Monitoring ◽  
Antihypertensive Medication ◽  
Neonatal Outcomes ◽  
Self Monitoring ◽  
Link Type ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Multicenter Randomized Controlled Trial ◽  
Patient Reported

Abstract Background Observational data from the retrospective, non-randomized Pregnancy REmote MOnitoring I (PREMOM I) study showed that remote monitoring (RM) may be beneficial for prenatal observation of women at risk for gestational hypertensive disorders (GHD) in terms of clinical outcomes, health economics, and stakeholder perceptions. PREMOM II is a prospective, randomized, multicenter follow-up study that was performed to explore these promising results. Methods After providing written consent, 3922 pregnant women aged ≥18 years who are at increased risk of developing GHD will be randomized (1:1:1 ratio) to (a) conventional care (control group), (b) a patient self-monitoring group, and (c) a midwife-assisted RM group. The women in each group will be further divided (1:1 ratio) to evaluate the outcomes of targeted or non-targeted (conventional) antihypertensive medication. Women will be recruited in five hospitals in Flanders, Belgium: Ziekenhuis Oost-Limburg, Universitaire Ziekenhuis Antwerpen, Universitaire Ziekenhuis Leuven, AZ Sint Jan Brugge–Oostende, and AZ Sint Lucas Brugge. The primary outcomes are: (1) numbers and types of prenatal visits; (2) maternal outcomes; (3) neonatal outcomes; (4) the applicability and performance of RM; and (5) compliance with RM and self-monitoring. The secondary outcomes are: (1) cost-effectiveness and willingness to pay; (2) patient-reported outcome measures (PROMS) questionnaires on the experiences of the participants; and (3) the maternal and perinatal outcomes according to the type of antihypertensive medication. Demographic, and maternal and neonatal outcomes are collected from the patients’ electronic records. Blood pressure and compliance rate will be obtained from an online digital coordination platform for remote data handling. Information about the healthcare-related costs will be obtained from the National Coordination Committee of Belgian Health Insurance Companies (Intermutualistisch Agentschap). PROMS will be assessed using validated questionnaires. Discussion To our knowledge, this is the first randomized trial comparing midwife-assisted RM and self-monitoring of prenatal blood pressure versus conventional management among women at increased risk of GHD. Positive results of this study may lead to a practical framework for caregivers, hospital management, and payers to introduce RM into the prenatal care programs of high-risk pregnancies. Trial registration This study was registered on clinicaltrials.gov, identification number NCT04031430. Registered 24 July 2019, https://clinicaltrials.gov/ct2/show/NCT04031430?cond=premom+ii&draw=2&rank=1.

Adoption of Telehealth: Remote Biometric Monitoring among Peritoneal Dialysis Patients in the United States

2017 ◽  
Vol 37 (5) ◽  
pp. 576-578 ◽  
Author(s):  
Susie Q. Lew ◽  
Neal Sikka ◽  
Clinton Thompson ◽  
Teena Cherian ◽  
Manya Magnus
Keyword(s):  
Blood Pressure ◽  
Peritoneal Dialysis ◽  
Real Time ◽  
Remote Monitoring ◽  
Call Center ◽  
The United States ◽  
Self Monitoring ◽  
Frequency Of Use ◽  
The Relationship ◽  
Monitoring Devices

We examined participant uptake and utilization of remote monitoring devices, and the relationship between remote biometric monitoring (RBM) of weight (Wt) and blood pressure (BP) with self-monitoring requirements. Participants on peritoneal dialysis (PD) (n = 269) participated in a Telehealth pilot study of which 253 used remote monitoring of BP and 255 for Wt. Blood pressure and Wt readings were transmitted in real time to a Telehealth call center, which were then forwarded to the PD nurses for real-time review. Uptake of RBM was substantial, with 89.7% accepting RBM, generating 74,266 BP and 52,880 Wt measurements over the study period. We found no significant correlates of RBM uptake with regard to gender, marital, educational, socio-economic or employment status, or baseline experience with computers; frequency of use of BP RBM by Black participants was less than non-Black participants, as was Wt RBM, and participants over 55 years old were more likely to use the Wt RBM than their younger counterparts. Having any review of the breach by a nurse was associated with reduced odds of a subsequent BP breach after adjusting for sex, age, and race. Remote biometric monitoring was associated with adherence to self-monitoring BP and Wt requirements associated with PD. Remote biometric monitoring was feasible, allowing for increased communication between patient and PD clinical staff with real-time patient data for providers to act on to potentially improve adherence and outcomes.

scholarly journals A Remote Medical Monitoring System for Heart Failure Prognosis

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Liangqing Zhang ◽  
Cuirong Yu ◽  
Chunrong Jin ◽  
Dajin Liu ◽  
Zongwen Xing ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Body Weight ◽  
Data Storage ◽  
Remote Monitoring ◽  
Support Vector ◽  
Present System ◽  
Medical Monitoring ◽  
Scoring Method ◽  
Failure Prognosis

Remote monitoring of heart disease provides the means to keep patients under continuous supervision. In this paper, we introduce the design and implementation of a remote monitoring medical system for heart failure prediction and management. The three-part system includes a patient-end for data collection, a medical data center as data storage and analysis, and a doctor-end to diagnosis and intervention. The main objective of the system is to prognose the occurrence risk of heart failure (HF) confirmed by the level of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) based on the changes of the patients’ (systolic and diastolic) blood pressure and body weight that are measured noninvasively in a home environment. The prediction of HF and non-HF patients was achieved by a structured support vector machine (SVM) classification algorithm. With the present system, we also proposed a scoring method to interpret the long-term risk of HF. We demonstrated the efficiency of the system with a pilot clinical study of 34 samples, where the NT-proBNP test was used to help train the prediction model as well as check the prediction results for our system. Results showed an accuracy of 79.4% for predicting HF on day 7 based on daily body weight and blood pressure data acquired over 30 days.

scholarly journals Integration and Adoption Analysis of Digital Health Monitoring Devices: Reflections of a Pilot Project (Preprint)

2018 ◽  
Author(s):  
Christopher Park ◽  
Emmamuzo Otobo ◽  
Jason Rogers ◽  
Farah Fasihuddin ◽  
Shashank Garg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Monitoring System ◽  
Remote Monitoring ◽  
Hospital Readmissions ◽  
Smart Devices ◽  
Remote Monitoring System ◽  
Factors Associated ◽  
Digital Medicine ◽  
Monitoring Devices

BACKGROUND Congestive heart failure (CHF) is a disease that affects about 6.5 million people in the United States with a mortality rate of around 30%. With the incidence rate projected to rise by 46% to exceed 8 million cases by 2030, projections estimate that total CHF costs will increase about to nearly $70 billion. Recently, the advent of remote monitoring technology has significantly broadened the scope of the physician’s reach in chronic disease management. Using remotely monitored health data, providers may be able to better manage and predict their patients’ outcomes, leading to reduced incidence and hospital admission costs. OBJECTIVE This project aimed to demonstrate the feasibility of a digital medicine engagement platform for CHF patients, including identifying factors associated with increased risk of readmission and assessing usage patterns of remote monitoring devices. METHODS The project included 60 patients admitted to Mount Sinai Hospital for CHF. A digital medicine platform by Rx.Health, called RxUniverse, was used to prescribe HealthPROMISE and iHealth mobile apps. Patients updated and recorded their CHF-related symptoms and quality of life measures daily on HealthPROMISE. Vital sign data, including blood pressure and weight, were collected through an ambulatory remote monitoring system that integrated the iHealth app and complementary consumer grade Bluetooth-connected smart devices (blood pressure cuff and digital scale). Physicians were notified of abnormal patient blood pressure and weight change readings and further action was left to the physician’s discretion. We used statistical analyses to determine risk factors associated with 30-day all-cause readmission. RESULTS Overall, there were six 30-day hospital readmissions (10%), compared to the national readmission rates of around 25%. Single marital status (P<.1) and history of percutaneous coronary intervention (P<.1) were associated with readmission. Readmitted patients were also less likely to have been previously prescribed angiotensin converting enzyme inhibitors or angiotensin II receptor blockers (P<.05). Notably, readmitted patients utilized the blood pressure and weight monitors less than non-readmitted patients, and patients aged less than 70 used the monitors more frequently on average than those over 70, though these trends did not reach statistical significance. The percentage of patients using the monitors at least once dropped steadily from 83% in the first week after discharge to 46% in the fourth week. Additionally, 88% of patients used the monitor at least 4 times and 62% at least 10 times, with some patients using the monitors multiple times per day. CONCLUSIONS Given the increasing burden of CHF, there is a need for an effective and sustainable remote monitoring system for CHF patients following hospital discharge. We identified clinical and social factors as well as remote monitor usage trends that identify targetable patient populations that could benefit most from integration of daily remote monitoring. In addition, we demonstrated that interventions driven by real-time vitals data may greatly aid in reducing hospital readmissions and costs while improving patient outcomes. Future studies should seek to implement remote monitoring and confirm usage trends as well as risk factors in a large-scale population.

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