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远程患者监测 (RPM) 项目与 COVID-19 癌症患者住院减少的关联。

Association of a Remote Patient Monitoring (RPM) Program With Reduced Hospitalizations in Cancer Patients With COVID-19.

机构信息

Division of Hematology, Mayo Clinic, Rochester, MN.

Division of Medical Oncology, Mayo Clinic, Rochester, MN.

出版信息

JCO Oncol Pract. 2021 Sep;17(9):e1293-e1302. doi: 10.1200/OP.21.00307. Epub 2021 Jun 4.

Abstract

PURPOSE

The goal of this study was to assess the impact of an interdisciplinary remote patient monitoring (RPM) program on clinical outcomes and acute care utilization in cancer patients with COVID-19.

METHODS

This is a cross-sectional analysis following a prospective observational study performed at Mayo Clinic Cancer Center. Adult patients receiving cancer-directed therapy or in recent remission on active surveillance with polymerase chain reaction-confirmed SARS-CoV-2 infection between March 18 and July 31, 2020, were included. RPM was composed of in-home technology to assess symptoms and physiologic data with centralized nursing and physician oversight.

RESULTS

During the study timeframe, 224 patients with cancer were diagnosed with COVID-19. Of the 187 patients (83%) initially managed in the outpatient setting, those who did not receive RPM were significantly more likely to experience hospitalization than those receiving RPM. Following balancing of patient characteristics by inverse propensity score weighting, rates of hospitalization for RPM and non-RPM patients were 2.8% and 13%, respectively, implying that the use of RPM was associated with a 78% relative risk reduction in hospital admission rate (95% CI, 54 to 102; = .002). Furthermore, when hospitalized, these patients experienced a shorter length of stay and fewer prolonged hospitalizations, intensive care unit admissions, and deaths, although these trends did not reach statistical significance.

CONCLUSION

The use of RPM and a centralized virtual care team was associated with a reduction in hospital admission rate and lower overall acute care resource utilization among cancer patients with COVID-19.

摘要

目的

本研究旨在评估跨学科远程患者监测(RPM)计划对 COVID-19 癌症患者临床结局和急性护理利用的影响。

方法

这是在梅奥诊所癌症中心进行的前瞻性观察研究之后进行的横断面分析。纳入 2020 年 3 月 18 日至 7 月 31 日期间接受癌症定向治疗或最近在主动监测中缓解并经聚合酶链反应确认 SARS-CoV-2 感染的成年癌症患者。RPM 由家庭内技术组成,用于评估症状和生理数据,并进行集中护理和医生监督。

结果

在研究期间,有 224 例癌症患者被诊断出患有 COVID-19。在最初在门诊管理的 187 例患者中(83%),未接受 RPM 的患者比接受 RPM 的患者更有可能住院。通过逆概率倾向评分加权平衡患者特征后,RPM 和非-RPM 患者的住院率分别为 2.8%和 13%,这意味着 RPM 的使用与住院率降低 78%相关(95%CI,54 至 102;=.002)。此外,当这些患者住院时,他们的住院时间更短,且较少出现长时间住院、入住重症监护病房和死亡的情况,尽管这些趋势没有达到统计学意义。

结论

RPM 的使用和集中虚拟护理团队与 COVID-19 癌症患者的住院率降低和整体急性护理资源利用率降低相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fd4/8457804/d6c25cf2883c/op-17-e1293-g002.jpg

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