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      Remote Patient Monitoring in Adults Receiving Transfusion or Infusion for Hematological Disorders Using the VitalPatch and accelerateIQ Monitoring System: Quantitative Feasibility Study

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          Abstract

          Background

          Frequent vital sign monitoring during and after transfusion of blood products and certain chemotherapies or immunotherapies is critical for detecting infusion reactions and treatment management in patients. Currently, patients return home with instructions to contact the clinic if they feel unwell. Continuous monitoring of vital signs for hematological patients treated with immunotherapy or chemotherapy or receiving blood transfusions using wearable electronic biosensors during and post treatment may improve the safety of these treatments and make remote data collection in an outpatient care setting possible.

          Objective

          This study aimed to evaluate patient experiences with the VitalPatch wearable sensor (VitalConnect) and to evaluate the usability of data generated by the physIQ accelerateIQ monitoring system for the investigator and nurse.

          Methods

          A total of 12 patients with hematological disorders receiving red blood cell transfusions, an intravenous (IV) proteasome inhibitor, or an IV immunotherapy agent were included in the study and wore the VitalPatch for 12 days. Patients completed questionnaires focusing on wearability and nurses completed questionnaires focusing on the usability of the VitalPatch.

          Results

          A total of 12 patients were enrolled over 9 months, with 4 receiving red blood cell transfusions, 4 receiving IV proteasome inhibitors, and 4 receiving IV immunotherapy. These patients were treated for diseases such as multiple myeloma, myelodysplastic syndrome, and non-Hodgkin lymphoma. Of these patients, 83% (10/12) were aged 60 years and older. A total of 4 patients (4/12, 33%) withdrew from the study (3 because of skin irritation and 1 because of patch connection issues). Patients wore biosensor patches at baseline and for 1-week post administration. Patient-reported outcomes (PROs) were collected at baseline, day 1, day 5, and day 8. No difference in the PRO was observed when nurses or patients applied the patch. PRO data indicated minimal impact on the patient’s life. Ease of use, influence on sleep, impact on follow-up of health, or discomfort with continuous monitoring did not change between baseline and day 8. Changes in PRO were observed on day 5, where a 20% (2/10) increase in skin irritation was reported. Withdrawals because of skin irritation were reported in all cases when wearing the second patch. Nurses reported the placement of the VitalPatch to be easy and felt measurements to be reliable.

          Conclusions

          Generally, the VitalPatch was well tolerated and shown to be an attractive device because of its wearability and low impact on daily activities in patients, therefore making it suitable for implementation in future studies.

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          Most cited references15

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              Respiratory rate: the neglected vital sign.

              The level of documentation of vital signs in many hospitals is extremely poor, and respiratory rate, in particular, is often not recorded. There is substantial evidence that an abnormal respiratory rate is a predictor of potentially serious clinical events. Nurses and doctors need to be more aware of the importance of an abnormal respiratory rate as a marker of serious illness. Hospital systems that encourage appropriate responses to an elevated respiratory rate and other abnormal vital signs can be rapidly implemented. Such systems help to raise and sustain awareness of the importance of vital signs.
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                Author and article information

                Contributors
                Journal
                JMIR Hum Factors
                JMIR Hum Factors
                JMIR Human Factors
                JMIR Human Factors
                JMIR Publications (Toronto, Canada )
                2292-9495
                Oct-Dec 2019
                2 December 2019
                : 6
                : 4
                : e15103
                Affiliations
                [1 ] Haga Teaching Hospital The Hague Netherlands
                [2 ] Transfusie- en Transplantatiereacties in Patiënten Leiden Netherlands
                [3 ] Leiden University Medical Center Leiden Netherlands
                [4 ] physIQ, Inc Chicago, IL United States
                [5 ] University Medical Center Groningen Groningen Netherlands
                Author notes
                Corresponding Author: Rik Paulus Bernardus Tonino Toninorik@ 123456gmail.com
                Author information
                https://orcid.org/0000-0002-6775-6617
                https://orcid.org/0000-0003-0023-618X
                https://orcid.org/0000-0002-5276-709X
                https://orcid.org/0000-0001-9201-9718
                Article
                v6i4e15103
                10.2196/15103
                6915430
                31789596
                085aaf38-4da6-445d-928c-5819b5f0a4b8
                ©Rik Paulus Bernardus Tonino, Karen Larimer, Okke Eissen, Martin Roelof Schipperus. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 02.12.2019.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Human Factors, is properly cited. The complete bibliographic information, a link to the original publication on http://humanfactors.jmir.org, as well as this copyright and license information must be included.

                History
                : 19 June 2019
                : 30 July 2019
                : 8 August 2019
                : 8 September 2019
                Categories
                Original Paper
                Original Paper

                infusions, intravenous,erythrocyte transfusion,transfusion reaction,wearable electronic devices,telemedicine

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