Remote Monitoring of Patients with COVID-19 after Hospital Discharge with Connected Health Platform: Outcomes and Quality of Life

Background: Telemonitoring with applications and connected devices facilitates a more accessible and efficient attention. Its implementation has been accelerated thanks to the pandemic by COVID-19, where they have allowed the continuity of care. Objective: To evaluate the efficacy of a remote monitoring platform for the outpatient follow-up after hospital discharge by COVID-19. Methods: Prospective observational study of patients discharged from the hospital with COVID-19 infection between March 23 and May 25, 2020, who were followed for one month with the Connected Health telemonitoring platform. The mobile phone application connected to a pulse oximeter, allowed to measure vital signs and answer health questionnaires (EQ5D3L and CAT) daily, and alert the medical team that could be contacted by video consultation. Results: 95 patients (64% male) with a mean age of 54 (SD 26-81) years were included. The application allowed the detection of alerts for pain (80% of patients) and a decrease in oxygen saturation (12%). No patient required hospital readmission or presented complications. The application allowed strict monitoring of symptoms and quality of life. The main symptom was severe pain (59% of patients) followed by anxiety or depression (25%). The average state of health was 65 (SD 20-100). COVID-19 caused a low impact on the quality of life of 62% of the patients, although 8% reported a significant limitation, due to shortness of breath and leaving the house. Conclusion: telemonitoring allows a safe remote monitoring of patients after hospital discharge by COVID-19. The Connected Health application has allowed the measurement of oxygen saturation, symptoms and quality of life, and the detection and management of alerts by the medical team through video consultation.

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Efficacy of Remote Monitoring of Overweight Patients with Connected Health Platform

Journal of Integrative Cardiology Open Access ◽

10.31487/j.jicoa.2020.04.17 ◽

2020 ◽

pp. 1-5

Author(s):

César Morcillo Serra ◽

Domingo Marzal Martín ◽

José Francisco Tomás Martínez

Keyword(s):

Quality Of Life ◽

Remote Monitoring ◽

Obesity Epidemic ◽

Mobile Phone Application ◽

Connected Health ◽

Video Consultation ◽

Multicenter Prospective Observational Study ◽

Health Application

Background: Mobile technology has emerged as a potentially useful platform to facilitate weight management and tackle the current obesity epidemic. Objective: To evaluate the efficacy of a remote monitoring platform for overweight patients. Methods: Multicenter prospective observational study of overweight patients seen in an endocrinology clinic of 5 healthcare centers, between August 2017 and August 2020, who were followed with the Connected Health telemonitoring platform. The mobile phone application connected to a scale and activity wristband, allowed to measure weight, activity, answer health questionnaire and its management by the medical team that could be contacted by video consultation. Results: 79 patients (57% female) with a mean age of 46,8 (SD 23-70) years were included with a mean follow-up of 12.9 months (SD 4-36). The application allowed to measure weight, activity and quality of life and no patient presented complications. The mean weight of all patients at the beginning of the intervention was 84.1 kg and at the end of the follow-up it was 82.4 kg, with a mean reduction of 1.7 kg (p<0.05). The average state of health of all patients at baseline was 62 (SD 34-100) and at the end of the follow-up was 66 (SD 38-100) (p<0.05). Conclusion: Telemonitoring allows a safe remote monitoring of overweight patients. The Connected Health application allowed the measurement of weight, activity and quality of life, and was associated with significant changes in body weight.

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Prospective observational study to examine health-related quality of life and develop models to predict long-term patient-reported outcomes 6 months after hospital discharge with blunt thoracic injuries

BMJ Open ◽

10.1136/bmjopen-2021-049292 ◽

2021 ◽

Vol 11 (7) ◽

pp. e049292

Author(s):

Edward Baker ◽

Ceri Battle ◽

Abhishek Banjeri ◽

Edward Carlton ◽

Christine Dixon ◽

...

Keyword(s):

Quality Of Life ◽

Hospital Discharge ◽

Brief Pain Inventory ◽

Thoracic Injuries ◽

Patient Reported ◽

Related Quality ◽

Paindetect Questionnaire ◽

Health Related

ObjectiveThis study aimed to examine the long-term outcomes and health-related quality of life in patients with blunt thoracic injuries over 6 months from hospital discharge and develop models to predict long-term patient-reported outcomes.DesignA prospective observational study using longitudinal survey design.SettingThe study recruitment was undertaken at 12 UK hospitals which represented diverse geographical locations and covered urban, suburban and rural areas across England and Wales.Participants337 patients admitted to hospital with blunt thoracic injuries were recruited between June 2018–October 2020.MethodsParticipants completed a bank of two quality of life surveys (Short Form-12 (SF-12) and EuroQol 5-Dimensions 5-Levels) and two pain questionnaires (Brief Pain Inventory and painDETECT Questionnaire) at four time points over the first 6 months after discharge from hospital. A total of 211 (63%) participants completed the outcomes data at 6 months after hospital discharge.Outcomes measuresThree outcomes were measured using pre-existing and validated patient-reported outcome measures. Outcomes included: Poor physical function (SF-12 Physical Component Score); chronic pain (Brief Pain Inventory Pain Severity Score); and neuropathic pain (painDETECT Questionnaire).ResultsDespite a trend towards improving physical functional and pain at 6 months, outcomes did not return to participants perceived baseline level of function. At 6 months after hospital discharge, 37% (n=77) of participants reported poor physical function; 36.5% (n=77) reported a chronic pain state; and 22% (n=47) reported pain with a neuropathic component. Predictive models were developed for each outcome highlighting important data collection requirements for predicting long-term outcomes in this population. Model diagnostics including calibration and discrimination statistics suggested good model fit in this development cohort.ConclusionsThis study identified the recovery trajectories for patients with blunt thoracic injuries over the first 6 months after hospital discharge and present prognostic models for three important outcomes which after external validation could be used as clinical risk stratification scores.

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Telerehabilitation Intervention in Patients with COVID-19 after Hospital Discharge to Improve Functional Capacity and Quality of Life. Study Protocol for a Multicenter Randomized Clinical Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062924 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2924

Author(s):

José-Manuel Pastora-Bernal ◽

María-José Estebanez-Pérez ◽

Guadalupe Molina-Torres ◽

Francisco-José García-López ◽

Raquel Sobrino-Sánchez ◽

...

Keyword(s):

Quality Of Life ◽

Clinical Trial ◽

Randomized Clinical Trial ◽

Hospital Discharge ◽

Study Protocol ◽

Functional Capacity ◽

Treatment Method ◽

Current Evidence ◽

Current Standard

COVID-19 can cause important sequels in the respiratory system and frequently presents loss of strength, dyspnea, polyneuropathies and multi-organic affectation. Physiotherapy interventions acquire a fundamental role in the recovery of the functions and the quality of life. Regarding the recovery phases after hospital discharge, the current evidence available is very preliminary. Telerehabilitation is presented as a promising complementary treatment method to standard physiotherapy. The main objective of this research is to evaluate the effectiveness of a personalized telerehabilitation intervention after discharge from hospital for the improvement of functional capacity and quality of life compared to a program of health education and/or care in a rehabilitation center. As secondary objectives, to identify the satisfaction and perception of patients with the telerehabilitation intervention and the presence of barriers to its implementation, as well as to evaluate the cost-effectiveness from the perspective of the health system. This study protocol will be carried out through a single blind multicenter randomized clinical trial in the south of Spain. We hypothesize that the implementation of a telerehabilitation program presents results not inferior to those obtained with the current standard intervention. If the hypothesis is confirmed, it would be an opportunity to define new policies and interventions to address this disease and its consequences. Trial registration NCT04742946.

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Quality of life of long term ICU patients at 6 months after hospital discharge

Critical Care ◽

10.1186/cc295 ◽

1998 ◽

Vol 2 (Suppl 1) ◽

pp. P166

Author(s):

I Novák ◽

V Šrámek ◽

E Bokrová ◽

M Bílek ◽

M Matejovic ◽

...

Keyword(s):

Quality Of Life ◽

Hospital Discharge ◽

Icu Patients

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Nutritional differences in malnourished patients according to their liquid-intake habits after hospital discharge

Nutrición Hospitalaria ◽

10.20960/nh.310 ◽

2016 ◽

Vol 33 (3) ◽

Author(s):

Cristina Casals ◽

María Ángeles Vázquez Sánchez ◽

José Luis Casals Sánchez ◽

Ernesto Suárez-Cadenas

Keyword(s):

Quality Of Life ◽

Body Mass Index ◽

Nutritional Status ◽

Hospital Discharge ◽

Body Mass ◽

Short Form ◽

Functional Dependency ◽

The Body ◽

Liquid Intake

Introduction: Malnutrition is a serious and relatively common problem among hospitalized patients; moreover, it is known that a good hydration state contributes to health and wellbeing. Objective: The aim of this study was to determine the relationship between nutritional status, functional dependency, quality of life and liquid-intake habits in malnourished patients after hospital discharge. Methods: Cross-sectional descriptive study in 91 patients (45 males) who presented malnutrition at hospital discharge. The patients were grouped according to their liquid intake estimated through the Mini Nutritional Assessment questionnaire: 3-5 glasses (n = 42), and > 5 glasses (n = 46); removing from analysis < 3 glasses of liquid intake (n = 3). The body mass index, weight, Malnutrition Universal Screening Tool (MUST), functional dependency (Barthel questionnaire), and quality of life (Short Form 12 Health Survey [SF-12]) were assessed 2-months after discharge. Results: The > 5 glasses liquid intake group showed better nutritional status than the 3-5 glasses intake group, for weight (p < 0.001), body mass index (p = 0.001), and MUST scale (p = 0.020). Additionally, the > 5 glasses liquid intake group signifi cantly scored higher values in the total SF-12 questionnaire (p = 0.013), presenting better self-reported quality of life, and higher functional independency in the Barthel index (p = 0.037) than the 3-5 glasses liquid intake group (p = 0.013). Conclusions: Although further research is needed to elucidate the characteristics of this relationship, descriptive comparisons between groups showed favorable nutritional status, functional independency and quality of life for the > 5 glasses of liquid intake compared with the 3-5 glasses of liquid intake group during a 2-months follow-up.

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Anesthesia in the Radiation Oncology Suite

Anesthesia Outside of the Operating Room ◽

10.1093/med/9780195396676.003.0014 ◽

2011 ◽

pp. 143-150

Author(s):

Eric A. Harris ◽

Keith Candiotti

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Radiation Oncology ◽

Care Physician ◽

Medical Team ◽

Multimodal Approach ◽

Radiation Oncologist ◽

Vital Component ◽

Developed World

Cancer continues to be a leading cause of death in the developed world, with physicians and scientists constantly devising new weapons to combat it. Chemotherapy, surgery, nutrition, and holistic medicine all have a place in the multimodal approach that can prolong longevity and ameliorate quality of life. As part of this armamentarium, radiation therapy (XRT) has proven to be a safe and effective technique for the management of various malignant (and occasionally nonmalignant) lesions. XRT can be used for both curative and palliative purposes; in the latter case, patients benefit from decreased pain, preserved organ function, and the maintenance of lumen patency in hollow organs.1 The medical team, led by a radiation oncologist, often includes a physicist, a dosimetrist, several radiation therapists (technologists), and the patient’s primary care physician.2 Anesthesiologists are increasingly being asked to join this team, as our services are recognized as a vital component for patient safety and comfort.

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Quality of life after cardiac arrest: How and when to assess outcomes after hospital discharge?

Resuscitation ◽

10.1016/j.resuscitation.2014.06.018 ◽

2014 ◽

Vol 85 (9) ◽

pp. 1127-1128 ◽

Cited By ~ 4

Author(s):

Karen Smith ◽

Stephen Bernard

Keyword(s):

Quality Of Life ◽

Cardiac Arrest ◽

Hospital Discharge

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Individual attributions of living longer with HER2+ metastatic breast cancer: Findings from a community web-based survey.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.30_suppl.197 ◽

2014 ◽

Vol 32 (30_suppl) ◽

pp. 197-197 ◽

Cited By ~ 1

Author(s):

Musa Mayer ◽

Matthew Sussman ◽

Anthony Masaquel ◽

Tripthi Kamath ◽

Catherine Lai ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Metastatic Breast Cancer ◽

Metastatic Breast ◽

Medical Team ◽

Inclusion Criteria ◽

Web Based ◽

The Right ◽

Positive Outlook

197 Background: Advances in targeted therapy have led to an increase in the median overall survival in patients with HER2+ metastatic breast cancer (MBC). However, patient attributions related to living longer have not been studied. Methods: A one-time, web-based survey was administered through multiple US-based breast cancer organizations. The inclusion criteria were being female, age 18+, having HER2+ MBC, and living in the US. The surveys included health related quality of life (HRQL), symptom burden, activities of daily living, satisfaction with medical care, work productivity, and attributes of living longer. To assess beliefs about length of survival with HER2+ MBC, participants were asked to rate the importance of 16 items. Descriptive results were stratified by time since metastatic diagnosis and HRQL. Results: Of 560 attempted surveys, 365 (65%) participants met inclusion criteria. Mean (SD) age was 53.6 (10.5) years, 93% were white, and 27% reported having participated in a clinical trial. 59% of respondents reported living ≥4 years since HER2+ MBC diagnosis. Common reasons patients gave for living longer included: choosing the right doctor/medical team (91%), having a positive outlook on life (79%), and learning about the disease or treatments (79%). Women with <4 years since HER2+ MBC diagnosis were more likely to report having a positive outlook on life (85% vs 76%), using complementary and alternative medicine (45% vs 36%) and exercising regularly (74% vs 66%) compared with those having ≥4 years since diagnosis. Women reporting a better compared with a poorer HRQL reported more frequent regular exercise (73% vs 49%) and more often had a positive outlook on life (86% vs 64%). Conclusions: To our knowledge, this is the first study of women with HER2+ MBC and their attributions about length of survival. Having the right medical team, remaining positive, and being educated about the disease and its treatments were most important to participants. Women reporting better quality of life were more likely to report multiple attributions of living longer. HRQL and patient perceptions about their survival are important factors that should be considered in providing patient-centered care.

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