Telemonitoring in chronic ventilatory failure: a new model of survellaince, a pilot study

https://doi.org/10.4081/monaldi.2012.153

Authors

  • S. Bertini | bertinis@aou-careggi.toscana.it Respiratory Intensive Care Unit, AOU - Careggi, Firenze, Italy.
  • M. Picariello Respiratory Intensive Care Unit, AOU - Careggi, Firenze, Italy.
  • M. Gorini Respiratory Intensive Care Unit, AOU - Careggi, Firenze, Italy.
  • T. Renda Respiratory Intensive Care Unit, AOU - Careggi, Firenze, Italy.
  • A. Augustynen Respiratory Intensive Care Unit, AOU - Careggi, Firenze, Italy.
  • G. Villella Respiratory Intensive Care Unit, AOU - Careggi, Firenze, Italy.
  • G. Misuri Respiratory Intensive Care Unit, AOU - Careggi, Firenze, Italy.
  • N.M. Maluccio Respiratory Intensive Care Unit, AOU - Careggi, Firenze, Italy.
  • R. Ginanni Respiratory Intensive Care Unit, AOU - Careggi, Firenze, Italy.
  • D. Tozzi Respiratory Intensive Care Unit, AOU - Careggi, Firenze, Italy.
  • A. Corrado Respiratory Intensive Care Unit, AOU - Careggi, Firenze, Italy.

Abstract

Background and Aim. The efficiency of tele-monitoring or tele-assistance in patients with severe chronic ventilatory failure in home mechanical ventilation (HMV) is still being investigated. Our aim was to test the feasibility of a model which consisted in: 1) once a week nocturnal telemonitoring, supervised by a doctor in charge in a Respiratory Intensive Care Unit, who also provided a telephone-counselling (24/7) on demand; 2) a scheduled visit every two months. Methods. A 2-year observational study was carried out on 16 patients ventilated for at least 1 year and for ≥ 8 hours /day. Once a week patients underwent a nocturnal monitoring during HMV. The compliance was evaluated by regular transmission of data and regular follow-up, the level of satisfaction by a telephonequestionnaire. Results. The adherence to the protocol study was good in 9/16 (56%) and poor in 7/16 (44%) patients. For each patient, the mean number of connections was 46,12 ± 36.39 (70.7% of that expected), in those with good compliance it increased to 63.8 ± 32.7 (114% of that expected). The median hours of connection was 343 (138- 1019) and 89 (0-521) for patients with good and poor compliance respectively, p=0.038. The mean scheduled visits for patient with good compliance was 6.9 ± 4.14 (100% of that expected). Emergency visits were avoided in 62.5% of cases. The satisfaction score was higher in compliant versus non compliant patients (p=0.019). Conclusion. This pilot study showed that the telemonitoring system employed was feasible and effective in more compliant patients who claimed a high rate of satisfaction.

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Published
2015-12-03
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Original Articles
Keywords:
Chronic Respiratory Failure, Home Mechanical Ventilation, Respiratory Intensive Care Unit, Telehealth, Telemedicine.
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How to Cite
Bertini, S., M. Picariello, M. Gorini, T. Renda, A. Augustynen, G. Villella, G. Misuri, N.M. Maluccio, R. Ginanni, D. Tozzi, and A. Corrado. 2015. “Telemonitoring in Chronic Ventilatory Failure: A New Model of Survellaince, a Pilot Study”. Monaldi Archives for Chest Disease 77 (2). https://doi.org/10.4081/monaldi.2012.153.