Khetrapal Pramit, Stafford Ronnie, Ó Scanaill Pádraig, Kocadag Huriye, Timinis Constantinos, Chang Angela H L, Hadjivasiliou Adamos, Liu Yansong, Gibbs Olivia, Pickford Eleanor, Walker David, Baker Hilary, Duncan Jacqueline, Tan Melanie, Williams Norman, Catto James, Drobnjak Ivana, Kelly John
University College London, London, United Kingdom.
University College London Hospital, London, United Kingdom.
JMIR Res Protoc. 2022 Apr 6;11(4):e30638. doi: 10.2196/30638.
The incidence of major surgery is on the rise globally, and more than 20% of patients are readmitted to hospital following discharge from hospital. During their hospital stay, patients are monitored for early detection of clinical deterioration, which includes regularly measuring physiological parameters such as blood pressure, heart rate, respiratory rate, temperature, and pulse oximetry. This monitoring ceases upon hospital discharge, as patients are deemed clinically stable. Monitoring after discharge is relevant to detect adverse events occurring in the home setting and can be made possible through the development of digital technologies and mobile networks. Smartwatches and other technological devices allow patients to self-measure physiological parameters in the home setting, and Bluetooth connectivity can facilitate the automatic collection and transfer of this data to a secure server with minimal input from the patient.
This paper presents the protocol for the DREAMPath (Domiciliary Recovery After Medicalization Pathway) study, which aims to measure compliance with a multidevice remote monitoring kit after discharge from hospital following major surgery.
DREAMPath is a single-center, prospective, observational, cohort study, comprising 30 patients undergoing major intracavity surgery. The primary outcome is to assess patient compliance with wearable and interactive smart technology in the first 30 days following discharge from hospital after major surgery. Secondary outcomes will explore the relation between unplanned health care events and physiological data collected in the study, as well as to explore a similar relationship with daily patient-reported outcome measures (Quality of Recovery-15 score). Secondary outcomes will be analyzed using appropriate regression methods. Cardiopulmonary exercise testing data will also be collected to assess correlations with wearable device data.
Recruitment was halted due to COVID-19 restrictions and will progress once research staff are back from redeployment. We expect that the study will be completed in the first quarter of 2022.
Digital health solutions have been recently made possible due to technological advances, but urgency in rollout has been expedited due to COVID-19. The DREAMPath study will inform readers about the feasibility of remote monitoring for a patient group that is at an increased risk of acute deterioration.
ISRCTN Registry ISRCTN62293620; https://www.isrctn.com/ISRCTN62293620.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/30638.
全球范围内大手术的发生率呈上升趋势，超过20%的患者出院后再次入院。在住院期间，对患者进行监测以早期发现临床病情恶化，这包括定期测量生理参数，如血压、心率、呼吸频率、体温和脉搏血氧饱和度。出院后监测即停止，因为患者被认为临床状况稳定。出院后监测对于检测在家中发生的不良事件很有意义，并且通过数字技术和移动网络的发展可以实现。智能手表和其他技术设备使患者能够在家中自行测量生理参数，蓝牙连接可以促进这些数据的自动收集并以最少的患者输入将其传输到安全服务器。
本文介绍了DREAMPath（医疗化后居家康复路径）研究的方案，该研究旨在测量大手术后出院患者对多设备远程监测套件的依从性。
DREAMPath是一项单中心、前瞻性、观察性队列研究，包括30例接受大腔内手术的患者。主要结局是评估大手术后出院后头30天患者对可穿戴和交互式智能技术的依从性。次要结局将探讨计划外医疗保健事件与研究中收集的生理数据之间的关系，以及探讨与患者每日报告的结局指标（康复质量-15评分）的类似关系。次要结局将使用适当的回归方法进行分析。还将收集心肺运动测试数据以评估与可穿戴设备数据的相关性。
由于COVID-19限制，招募工作暂停，一旦研究人员从重新部署中返回，招募工作将继续进行。我们预计该研究将于2022年第一季度完成。
由于技术进步，数字健康解决方案最近成为可能，但由于COVID-19，其推出的紧迫性加快。DREAMPath研究将向读者介绍对急性病情恶化风险增加的患者群体进行远程监测的可行性。
ISRCTN注册库ISRCTN62293620；https://www.isrctn.com/ISRCTN62293620。
国际注册报告识别码（IRRID）：DERR1-10.2196/30638。
