scholarly journals Patient Adherence to Scheduled Vital Sign Measurements During Home Telemonitoring: Analysis of the Intervention Arm in a Before and After Trial (Preprint)

2017 ◽  
Author(s):  
Branko Celler ◽  
Ahmadreza Argha ◽  
Marlien Varnfield ◽  
Rajiv Jayasena
Keyword(s):  
Blood Pressure ◽  
Chronic Conditions ◽  
Patient Adherence ◽  
Vital Signs ◽  
Adherence Rate ◽  
Community Settings ◽  
Home Telemonitoring ◽  
Before And After ◽  
Different Levels ◽  
Over Time

BACKGROUND In a home telemonitoring trial, patient adherence with scheduled vital signs measurements is an important aspect that has not been thoroughly studied and for which data in the literature are limited. Levels of adherence have been reported as varying from approximately 40% to 90%, and in most cases, the adherence rate usually dropped off steadily over time. This drop is more evident in the first few weeks or months after the start. Higher adherence rates have been reported for simple types of monitoring and for shorter periods of intervention. If patients do not follow the intended procedure, poorer results than expected may be achieved. Hence, analyzing factors that can influence patient adherence is of great importance. OBJECTIVE The goal of the research was to present findings on patient adherence with scheduled vital signs measurements in the recently completed Commonwealth Scientific and Industrial Research Organisation (CSIRO) national trial of home telemonitoring of patients (mean age 70.5 years, SD 9.3 years) with chronic conditions (chronic obstructive pulmonary disease, coronary artery disease, hypertensive diseases, congestive heart failure, diabetes, or asthma) carried out at 5 locations along the east coast of Australia. We investigated the ability of chronically ill patients to carry out a daily schedule of vital signs measurements as part of a chronic disease management care plan over periods exceeding 6 months (302 days, SD 135 days) and explored different levels of adherence for different measurements as a function of age, gender, and supervisory models. METHODS In this study, 113 patients forming the test arm of a Before and After Control Intervention (BACI) home telemonitoring trial were analyzed. Patients were required to monitor on a daily basis a range of vital signs determined by their chronic condition and comorbidities. Vital signs included noninvasive blood pressure, pulse oximetry, spirometry, electrocardiogram (ECG), blood glucose level, body temperature, and body weight. Adherence was calculated as the number of days during which at least 1 measurement was taken over all days where measurements were scheduled. Different levels of adherence for different measurements, as a function of age, gender, and supervisory models, were analyzed using linear regression and analysis of covariance for a period of 1 year after the intervention. RESULTS Patients were monitored on average for 302 (SD 135) days, although some continued beyond 12 months. The overall adherence rate for all measurements was 64.1% (range 59.4% to 68.8%). The adherence rates of patients monitored in hospital settings relative to those monitored in community settings were significantly higher for spirometry (69.3%, range 60.4% to 78.2%, versus 41.0%, range 33.1% to 49.0%, P<.001), body weight (64.5%, range 55.7% to 73.2%, versus 40.5%, range 32.3% to 48.7%, P<.001), and body temperature (66.8%, range 59.7% to 73.9%, versus 55.2%, range 48.4% to 61.9%, P=.03). Adherence with blood glucose measurements (58.1%, range 46.7% to 69.5%, versus 50.2%, range 42.8% to 57.6%, P=.24) was not significantly different overall. Adherence rates for blood pressure (68.5%, range 62.7% to 74.2%, versus 59.7%, range 52.1% to 67.3%, P=.04), ECG (65.6%, range 59.7% to 71.5%, versus 56.5%, range 48.7% to 64.4%, P=.047), and pulse oximetry (67.0%, range 61.4% to 72.7%, versus 56.4%, range 48.6% to 64.1%, P=.02) were significantly higher in males relative to female subjects. No statistical differences were observed between rates of adherence for the younger patient group (70 years and younger) and older patient group (older than 70 years). CONCLUSIONS Patients with chronic conditions enrolled in the home telemonitoring trial were able to record their vital signs at home at least once every 2 days over prolonged periods of time. Male patients maintained a higher adherence than female patients over time, and patients supervised by hospital-based care coordinators reported higher levels of adherence with their measurement schedule relative to patients supervised in community settings. This was most noticeable for spirometry. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12613000635763; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364030&isReview=true (Archived by WebCite at http://www.webcitation.org/6xPOU3DpR).

HUBUNGAN PELAYANAN INFORMASI OBAT TERHADAP KEPATUHAN MINUM OBAT PASIEN HIPERTENSI DI RSUD PENAJAM PASER UTARA

2017 ◽  
Vol 3 (1) ◽  
pp. 7
Author(s):  
Triswanto Sentat
Keyword(s):  
Patient Adherence ◽  
Information Service ◽  
Rank Correlation ◽  
Pill Count ◽  
Adherence Rate ◽  
Validity And Reliability ◽  
Adherence To Medication ◽  
Count Method ◽  
Before And After ◽  
Questionnaire Method

The Drug Information Service or Pelayanan Informasi Obat (PIO) is indispensable for improving patient compliance with their treatment. With the PIO can change the knowledge and compliance of patients, especially hypertensive patients. This study was conducted to determine whether PIO can influence adherence to medication hypertension patients in RSUD Penajam Paser Utara. Sampling was done by purposive sampling and analyzed using Spearman Rank Correlation Test where the compliance aspect was assessed using validity and reliability tested questionnaire method, given before PIO and after PIO, and Pill Count method (calculating the remaining pills for 4 weeks) . Samples were obtained by 50 people, the results showed no improvement in adherence before and after PIO administration, and there was a relationship of compliance measurement results with questionnaire method after counseling and Pill Count method. The percentage of patient adherence after PIO administration was based on a high-compliance 70% (35 person) questionnaire method and based on the Pill Count method with a high adherence rate of 60% (30 persons), the compliance data obtained from both methods indicated that the provision of PIO can not improve compliance to take medication of hypertension patient of RSUD Penajam Paser Utara

scholarly journals Comparative Study of Heart Rate, Blood Pressure and Selective Attention of Subjects Before and After Music

2019 ◽  
Vol 4 (1) ◽  
pp. 625-628
Author(s):  
Nisha Ghimire ◽  
Renu Yadav ◽  
Soumitra Mukhopadhyay
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Reaction Time ◽  
Comparative Study ◽  
Error Correction ◽  
Vital Signs ◽  
Stroop Test ◽  
Before And After ◽  
Paired T Test ◽  
After Error

Introduction: Studies have shown different views regarding the effect of music in vitals e.g Heart rate (HR), Blood pressure (BP) and atiention. The effect of preferred music with lyrics in vitals and reaction time in stroop test has not been performed in Nepalese students so, we conducted the study. Objective: To find out the change in HR, BP and reaction time in Stroop test before and after their preferred music with lyrics. Methodology Thirty male medical and paramedical students aged 25.27 ± 2.0 participated in study. The vital signs and reaction time in Stroop test before and after music was taken. Results Paired-t test was used to compare means before and after exposure to music. The means are expressed as Mean ± SD. Heart rate (HR) increased after exposure to music (66.33±9.51 Vs 67.2±8.44) (p<.05). The error in Stroop test was less after music (.66±.49 Vs.63±.66) (p<.05). The reaction time after error correction decreased post exposure to music (24.117±4.61Vs23.29±4.45) (p<.05). Conclusion The heart rate increased after exposure to music. The errors decreased after listening to music which also decreased reaction time.

scholarly journals Comparison of Chest Compression Quality Using Wing Boards versus Walking Next to a Moving Stretcher: A Randomized Crossover Simulation Study

2020 ◽  
Vol 9 (5) ◽  
pp. 1584
Author(s):  
Yukako Nakashima ◽  
Takeji Saitoh ◽  
Hideki Yasui ◽  
Masahide Ueno ◽  
Kensuke Hotta ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chest Compression ◽  
Vital Signs ◽  
Borg Scale ◽  
Chest Compressions ◽  
High Quality ◽  
Compression Depth ◽  
Hands On ◽  
Before And After ◽  
Randomized Crossover Study

Background: When a rescuer walks alongside a stretcher and compresses the patient’s chest, the rescuer produces low-quality chest compressions. We hypothesized that a stretcher equipped with wing boards allows for better chest compressions than the conventional method. Methods: In this prospective, randomized, crossover study, we enrolled 45 medical workers and students. They performed hands-on chest compressions to a mannequin on a moving stretcher, while either walking (the walk method) or riding on wings attached to the stretcher (the wing method). The depths of the chest compressions were recorded. The participants’ vital signs were measured before and after the trials. Results: The average compression depth during the wing method (5.40 ± 0.50 cm) was greater than during the walk method (4.85 ± 0.80 cm; p < 0.01). The average compression rates during the two minutes were 215 ± 8 and 217 ± 5 compressions in the walk and wing methods, respectively (p = ns). Changes in blood pressure (14 ± 11 vs. 22 ± 14 mmHg), heart rate (32 ± 13 vs. 58 ± 20 bpm), and modified Borg scale (4 (interquartile range: 2–4) vs. 6 (5–7)) were significantly lower in the wing method cohort compared to the walking cohort (p < 0.01). The rescuer’s size and physique were positively correlated with the chest compression depth during the walk method; however, we found no significant correlation in the wing method. Conclusions: Chest compressions performed on the stretcher while moving using the wing method can produce high-quality chest compressions, especially for rescuers with a smaller size and physique.

Effects of subcutaneous esketamine on blood pressure and heart rate in treatment-resistant depression

2020 ◽  
Vol 34 (10) ◽  
pp. 1155-1162
Author(s):  
Lorena Catarina Del Sant ◽  
Luciana Maria Sarin ◽  
Eduardo Jorge Muniz Magalhães ◽  
Ana Cecília Lucchese ◽  
Marco Aurélio Tuena ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Vital Signs ◽  
Response To Treatment ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Post Dose ◽  
Before And After ◽  
Resistant Depression ◽  
The Impact

Introduction and objectives: The impact of multiple subcutaneous (s.c.) esketamine injections on the blood pressure (BP) and heart rate (HR) of patients with unipolar and bipolar treatment-resistant depression (TRD) is poorly understood. This study aimed to assess the cardiovascular safety of multiple s.c. doses of esketamine in patients with TRD. Methods: Seventy TRD patients received 394 weekly s.c. esketamine injections in conjunction with oral antidepressant therapy for up to six weeks. Weekly esketamine doses were 0.5, 0.75 or 1.0 mg/kg according to each patient’s response to treatment. Participants were monitored before each treatment and every 15 minutes thereafter for 120 minutes. We assessed systolic blood pressure (SBP), diastolic blood pressure (DBP), and HR measurements for the entire treatment course. Results: BP increased after the first s.c. esketamine injection, reaching maximum mean SBP/DBP levels of 4.87/5.54 mmHg within 30–45 minutes. At the end of monitoring, 120 minutes post dose, vital signs returned to pretreatment levels. We did not detect significant differences in BP between doses of 0.5, 0.75, and 1 mg/kg esketamine. Mean HR did not differ significantly between doses or before and after s.c. esketamine injection. Conclusions: The BP changes observed with repeated s.c. esketamine injections were mild and well tolerated for doses up to 1 mg/kg. The s.c. route is a simple and safe method of esketamine administration, even for patients with clinical comorbidities, including obesity, hypertension, diabetes, and dyslipidemia. However, 14/70 patients experienced treatment-emergent transient hypertension (SBP >180 mmHg and/or a DBP >110 mmHg). Therefore, we strongly recommend monitoring BP for 90 minutes after esketamine dosing. Since s.c. esketamine is cheap, requires less frequent dosing (once a week), and is a simpler procedure compared to intravenous infusions, it might have an impact on public health.

Home Telemonitoring of Patients With Type 2 Diabetes: A Meta-Analysis and Systematic Review

2022 ◽  
Author(s):  
Xu Zhu ◽  
Myia Williams ◽  
Kayla Finuf ◽  
Vidhi Patel ◽  
Liron Sinvani ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Meta Analysis ◽  
Automatic Transmission ◽  
Vital Signs ◽  
Vital Role ◽  
Study Duration ◽  
Home Telemonitoring ◽  
Moderate Interaction

Telehealth has emerged as an evolving care management strategy that is playing an increasingly vital role, particularly with the onset of the coronavirus disease 2019 pandemic. A meta-analysis of 20 randomized controlled trials was conducted to test the effectiveness of home telemonitoring (HTM) in patients with type 2 diabetes in reducing A1C, blood pressure, and BMI over a median 180-day study duration. HTM was associated with a significant reduction in A1C by 0.42% (P = 0.0084). Although we found statistically significant changes in both systolic and diastolic blood pressure (−0.10 mmHg [P = 0.0041], and −0.07 mmHg [P = 0.044], respectively), we regard this as clinically nonsignificant in the context of HTM. Comparisons across different methods of transmitting vital signs suggest that patients logging into systems with moderate interaction with the technology platform had significantly higher reductions in A1C than those using fully automatic transmission methods or fully manual uploading methods. A1C did not vary significantly by study duration (from 84 days to 5 years). HTM has the potential to provide patients and their providers with timely, up-to-date information while simultaneously improving A1C.

Abstract P156: Improvement In Blood Pressure Using Remote Patient Monitoring During COVID19

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Nadia A Liyanage-Don ◽  
Joseph E Schwartz ◽  
Nathalie Moise ◽  
Kelsey B Bryant ◽  
Adina Bono ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Patient Monitoring ◽  
Healthcare Access ◽  
Vital Signs ◽  
Primary Care Doctor ◽  
Remote Patient Monitoring ◽  
Nursing Support ◽  
Before And After ◽  
Remote Patient ◽  
The Impact

Introduction: The coronavirus disease 2019 (COVID19) pandemic required strict social distancing to curb transmission. Unfortunately, these measures severely limited healthcare access and chronic disease management. In response, many health organizations rapidly developed or expanded telemedicine to provide care directly to patients at home. Little has been reported about the impact of such interventions on clinical outcomes during COVID19. We examined whether enrollment in a remote patient monitoring (RPM) program for hypertension (HTN) prior to COVID19 was associated with improved blood pressure during the pandemic. Methods: We developed an RPM program that tracked vital signs, medication side effects, and treatment adherence patterns outside of the clinic. Patients were referred by their primary care doctor for uncontrolled HTN or suspected white coat HTN. Patients received a two-way tablet, blood pressure cuff, and virtual nursing support via scheduled video visits. Those referred for uncontrolled HTN who had at least two weeks of data both before and after the onset of COVID19 (defined as the first two weeks of March 2020) were included in the study. A mixed-models analysis that adjusted for serial autocorrelation was used to compare mean systolic blood pressure (SBP) and mean diastolic blood pressure (DBP) in the pre-/post-COVID19 periods. Results: Of 94 patients enrolled in the RPM program to date, 46 had at least two weeks of data both pre-COVID19 and post-COVID19. Mean age was 69.0 ± 10.9 years, 69.6% (32 of 46) were women, 78.3% (36 of 46) were Hispanic, and 63.0% (29 of 46) were Spanish-speaking. Pre-COVID, mean SBP was 132.31 ± 13.99 mmHg, mean DBP was 77.10 ± 9.87 mmHg, and 70% (32 of 46) of patients had uncontrolled BP (>130/80 mmHg per AHA guidelines). Post-COVID, mean SBP was 129.57 ± 13.29 mmHg, mean DBP was 76.00 ± 9.16 mmHg, and 57% (26 of 46) of patients had uncontrolled BP. There was a significant reduction in both mean SBP (β = –2.74, 95% CI –5.21, –0.26, p = 0.03) and mean DBP (β = –1.10, 95% CI –2.22, 0.02, p = 0.05) post-COVID vs. pre-COVID. Discussion: Despite the stress and social isolation associated with COVID19, participation in an RPM program that combines home BP monitoring with virtual nursing support can help maintain and even mildly decrease BP.

Comparing the effects of cold compress and Xyla-p cream on hemodynamic changes in hemodialysis patients during venipuncture

2019 ◽  
Vol 17 (2) ◽  
Author(s):  
Ziba Ghoreyshi ◽  
Monireh Amerian ◽  
Farzaneh Amanpour ◽  
Reza Mohammadpourhodki ◽  
Hossein Ebrahimi
Keyword(s):  
Blood Pressure ◽  
Physiological State ◽  
Vital Signs ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Intermittent Hemodialysis ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
The Difference

AbstractBackgroundThe vital signs reflect the physiological state of patients in various clinical conditions. The purpose of this study was to compare the effects of cold compress and Xyla-P cream on hemodynamical changes during venipuncture in hemodialysis patients.Methods and MaterialIn this clinical trial study, 50 patients under hemodialysis were selected by simple random sampling. The patients were then randomly assigned to either Xyla-P cream, cold compress or placebo groups. The vital signs (blood pressure and pulse) were measured upon two intermittent hemodialysis sessions before and after venipuncture. Data were analyzed using repeated measures analysis of variance.ResultsThe mean alternation in systolic blood pressure was significantly different comparing the placebo and cold compress groups before and after intervention (p<0.001). However, the difference was not significant between the Xyla-P cream group and either placebo (p=0.402) or ice compress (p=0.698) groups. The difference of the mean diastolic blood pressure was significant comparing the placebo group with either the Xyla-P cream group (p=0.003) or cold compress group (p<0.001) before and after intervention. In addition, there was a significant difference in the mean number of heartbeats comparing the control group with either the Xyla-P cream group (p<0.001) or cold compress group (p<0.001) before and after the intervention.ConclusionsConsidering the beneficial effects of ice compress and the Xyla-P cream on reduction of cardiovascular parameters, it is recommended to use these methods in hemodialysis patients during venipuncture.

scholarly journals PERBEDAAN TANDA- TANDA VITAL DAN EKG SEBELUM DAN SESUDAH REHABILITASI JANTUNG FASE 1 PADA PASIEN PENYAKIT JANTUNG KORONER

2021 ◽  
Vol 2 (3) ◽  
pp. 167-178
Author(s):  
Kuspariyah Romelah
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiac Rehabilitation ◽  
Phase 1 ◽  
Vital Signs ◽  
Test Design ◽  
Before And After ◽  
Post Test ◽  
Sample Test

ABSTRAK Penyakit jantung koroner adalah penimbunan plak pada pembuluh darah koroner, sehingga menyebabkan arteri koroner menyempit atau tersumbat. Tujuan penelitian ini untuk menganalisis  perbedaan tanda- tanda vital dan ekg sebelum dan sesudah rehabilitasi jantung fase 1 pada pasien penyakit jantung koroner.  Desain penelitian ini one Group Pre dan Post Test Design. Pengambilan sampel menggunakan tehnik purposive sampling dengan jumlah sampel 32 responden pasien. Analisa data menggunakan uji  Pairet T Sample test. Hasil penelitian  yang menunjukkan  normal sebelum   rehabilitasi jantung fase 1  tekanan darah sistole  65,63%, tekanan darah diastole 78,12%,  nadi 78,13%, respirasi 100%, suhu 87,5%, ekg 68,75%. Dan yang menunjukkan normal  sesudah  rehabilitasi jantung fase 1 yaitu   tekanan darah sistole 75% , tekanan darah diastole  93,75%,  nadi 68,75%, respirasi 68,75%, suhu 100% ekg 87,5%. Hasil uji statistik Pairet T Sample Test didapatkan 0,012 (< 0,05).  Kesimpulannya  adalah ada perbedaan tanda- tanda vital dan ekg sebelum dan sesudah  rehabilitasi jantung fase 1 pada pasien penyakit jantung koroner di IPJT RSSA Malang.   Kata kunci : Rehabilitasi, Tanda- tanda vital, Penyakit Jantung Koroner     ABSTRACT Coronary heart disease is the accumulation of plaque in the coronary arteries, causing the coronary arteries to become narrowed or blocked. The purpose of this study was to analyze the differences in vital signs and ECG before and after phase 1 cardiac rehabilitation in patients with coronary heart disease. The design of this research is one group pre and post test design. Sampling using purposive sampling technique with a sample of 32 patient respondents. Analysis of the data using the Pairet T Sample test. The results showed normal before cardiac rehabilitation phase 1 systolic blood pressure 65.63%, diastolic blood pressure 78.12%, pulse 78.13%, respiration 100%, temperature 87.5%, ecg 68.75%. And what showed normal after phase 1 cardiac rehabilitation were systolic blood pressure 75%, diastolic blood pressure 93.75%, pulse 68.75%, respiration 68.75%, temperature 100% ecg 87.5%. The results of the Pairet T Sample Test statistical test obtained 0.012 (<0.05). The conclusion is that there are differences in vital signs and ECG before and after phase 1 cardiac rehabilitation in coronary heart disease patients at IPJT RSSA Malang.   Key words :  Rehabilitation, Vital signs, Coronary Heart Disease

Vigilance and fatigue following traumatic brain injury

2006 ◽  
Vol 12 (1) ◽  
pp. 100-110 ◽  
Author(s):  
CARLO ZIINO ◽  
JENNIE PONSFORD
Keyword(s):  
Blood Pressure ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Vigilance Task ◽  
Attention Task ◽  
Subjective Fatigue ◽  
Before And After ◽  
Research Findings ◽  
Stable Performance ◽  
Over Time

Research findings have suggested that individuals with traumatic brain injury (TBI) show greater psychophysiological and subjective costs associated with performing vigilance tasks, but have not examined relationships with fatigue. The present study aimed to investigate vigilance and its relationship with subjective and objective fatigue measures. Forty-six TBI participants and 46 controls completed a 45-minute vigilance task. They also completed a subjective fatigue scale (the VAS-F) and a selective attention task before and after the vigilance task, and had their blood pressure (BP) monitored. TBI participants performed at a lower level on the vigilance task, but performed at a similar level across the duration of the task. Higher subjective fatigue ratings on the VAS-F were associated with more misses on the vigilance task for TBI participants. TBI participants showed greater increases in diastolic BP, and these were associated with greater increases in subjective fatigue ratings on the VAS-F. A subgroup of TBI participants showed a decline in performance on the vigilance task and also showed disproportionate increases in subjective fatigue. Findings provide support for the coping hypothesis, suggesting that TBI individuals expend greater psychophysiological costs in order to maintain stable performance over time, and that these costs are also associated with subjective increases in fatigue. (JINS, 2006,12, 100–110.)

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