Innovative Telemonitoring Enhanced Care program for CHF (ITEC-CHF): Usability and Patient Perspectives (Preprint)

BACKGROUND Telemonitoring enables care providers to remotely support outpatients in self-managing chronic heart failure (CHF), but little is known about usability and patients’ willingness to engage with this technology. OBJECTIVE To evaluate patients’ feedback following participation in the Innovative Telemonitoring Enhanced Care program for CHF (ITEC-CHF) study. METHODS Survey feedback on the usability of ITEC-CHF was collected in participants following 6 months of telemonitoring of their body weight. Responses were provided on a five-point Likert-scale and through and open-ended questions to determine the perceived benefits and barriers to using ITEC-CHF. RESULTS 67 participants (73% male), aged 69.8 ± 12.4 completed the survey. The majority of participants agreed or strongly agreed that the ITEC-CHF program was easy to use (91%), easy to navigate (78%), useful (91%), and made them feel more confident in managing their weight (85%). Themes related to participants’ perceptions of telemonitoring included: (1) increased support for early intervention of clinical deterioration; (2) improved compliance with daily weighing; (3) a sense of reassurance; (4) improved self-care and accountability. CONCLUSIONS ITEC-CHF was rated highly on usability and was well accepted by users as part of their routine self-management activities. Participants were willing to use telemonitoring because they perceived many benefits for CHF management. CLINICALTRIAL This study complies with the Declaration of Helsinki. The clinical trial protocol was approved by the Health Human Research Ethics Committee in Victoria (HREC Reference: HREC/14/PH/27), and Western Australia (Reference: 15-081, and Reference: HR 181/2014), Australia. The trial was registered with Australian New Zealand Clinical Trial Registry (Trial ID: ACTRN 12614000916640; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366691). Informed consent was obtained from the participants in the trial.

Comparison of the Perioperative and Postoperative Effects of Levobupivacaine and of Levobupivacaine + Adrenaline in Pediatric Tonsillectomy: A Double-Blind Randomized Study

Objectives. We aimed to assess the effects of levobupivacaine and of levobupivacaine + adrenaline administered during pediatric tonsillectomy on the postoperative period. Methods. A total of 90 patients between the ages of five and twelve were divided randomly into two groups before tonsillectomy: levobupivacaine only (0.5%) 0.4 mg·kg−1 or levobupivacaine (0.5%) 0.4 mg·kg−1 + adrenaline (1 : 200.000) administered by means of peritonsillar infiltration. Primary outcomes were postoperative pain scores recorded at various intervals until 24 hours postoperatively. Secondary outcomes included postoperative nausea and vomiting (PONV), time to first oral intake, time to the first administration of analgesics and total consumption of analgesics, and the amount of bleeding for all children. Results. In both groups, patients had the same postoperative pain scores and PONV rates, and equal amounts of analgesics were consumed up to 24 hours postoperatively. The two groups also had the same time until first oral intake, recovery time and time to the first analgesic request, and amount of bleeding. Conclusions. Perioperative levobupivacaine infiltration on its own is a valid alternative to the combination of levobupivacaine + adrenaline for perioperative and postoperative effectiveness in pediatric tonsillectomy. This trial is registered with Australian New Zealand Clinical Trial Registry ACTRN: ACTRN12617001167358.