Tonino Rik Paulus Bernardus, Larimer Karen, Eissen Okke, Schipperus Martin Roelof
Haga Teaching Hospital, The Hague, Netherlands.
Transfusie- en Transplantatiereacties in Patiënten, Leiden, Netherlands.
JMIR Hum Factors. 2019 Dec 2;6(4):e15103. doi: 10.2196/15103.
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.
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.
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.
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.
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.
在输注血液制品以及进行某些化疗或免疫治疗期间及之后,频繁监测生命体征对于检测患者的输液反应和治疗管理至关重要。目前,患者回家时会收到指示,若感觉不适需联系诊所。在免疫治疗或化疗的血液学患者治疗期间及之后,或输血过程中,使用可穿戴电子生物传感器持续监测生命体征,可能会提高这些治疗的安全性,并使门诊护理环境中的远程数据收集成为可能。
本研究旨在评估患者对VitalPatch可穿戴传感器(VitalConnect)的体验,并评估physIQ accelerateIQ监测系统生成的数据对研究者和护士的可用性。
共有12例接受红细胞输血、静脉注射蛋白酶体抑制剂或静脉注射免疫治疗药物的血液系统疾病患者纳入本研究,并佩戴VitalPatch 12天。患者完成了关于可穿戴性的问卷,护士完成了关于VitalPatch可用性的问卷。
在9个月内共招募了12例患者,其中4例接受红细胞输血,4例接受静脉注射蛋白酶体抑制剂,4例接受静脉注射免疫治疗。这些患者接受了诸如多发性骨髓瘤、骨髓增生异常综合征和非霍奇金淋巴瘤等疾病的治疗。在这些患者中,83%(10/12)年龄在60岁及以上。共有4例患者(4/12,33%)退出研究(3例因皮肤刺激,1例因贴片连接问题)。患者在基线时以及给药后第1周佩戴生物传感器贴片。在基线、第1天、第5天和第8天收集患者报告的结局(PRO)。护士或患者粘贴贴片时,PRO无差异。PRO数据表明对患者生活的影响最小。从基线到第8天,易用性、对睡眠的影响、对健康随访的影响或连续监测的不适感均未改变。在第5天观察到PRO有变化,报告皮肤刺激增加了20%(2/10)。佩戴第二片贴片时,所有病例均报告因皮肤刺激而退出。护士报告VitalPatch的粘贴很容易,并且感觉测量结果可靠。
总体而言,VitalPatch耐受性良好,因其可穿戴性和对患者日常活动影响小而被证明是一种有吸引力的设备,因此适合在未来研究中应用。