Interdisciplinary Research Education and Innovation in Health Systems (IRIS) Centre, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, D04 V1W8, Ireland.
BMC Health Serv Res. 2023 Aug 3;23(1):826. doi: 10.1186/s12913-023-09526-0.
COVID-19 has challenged health services throughout the world in terms of hospital capacity and put staff and vulnerable populations at risk of infection. In the face of these challenges, many health providers have implemented remote patient monitoring (RPM) of COVID-19 patients in their own homes. However systematic reviews of the literature on these implementations have revealed wide variations in how RPM is implemented; along with variations in particulars of RPM reported on, making comparison and evaluation difficult. A review of reported items is warranted to develop a framework of key items to enhance reporting consistency. The aims of this review of remote monitoring for COVID-19 patients are twofold: (1) to facilitate comparison between RPM implementations by tabulating information and values under common domains. (2) to develop a reporting framework to enhance reporting consistency.
A review of the literature for RPM for COVID-19 patients was conducted following PRISMA guidelines. The Medline database was searched for articles published between 2020 to February 2023 and studies reporting on items with sufficient detail to compare one with another were included. Relevant data was extracted and synthesized by the lead author. Quality appraisal was not conducted as the the articles considered were evaluated as informational reports of clinical implementations rather than as studies designed to answer a research question.
From 305 studies retrieved, 23 studies were included in the review: fourteen from the US, two from the UK and one each from Africa, Ireland, China, the Netherlands, Belgium, Australia and Italy. Sixteen generally reported items were identified, shown with the percentage of studies reporting in brackets: Reporting Period (82%), Rationale (100%), Patients (100%), Medical Team (91%) Provider / Infrastructure (91%), Communications Platform (100%), Patient Equipment (100%), Training (48%), Markers (96%), Frequency of prompt / Input (96%),Thresholds (82%), Discharge (61%), Enrolled (96%), Alerts/Escalated (78%), Patient acceptance (43%), and Patient Adherence (52%). Whilst some studies reported on patient training and acceptance, just one reported on staff training and none on staff acceptance.
Variations in reported items were found. Pending the establishment of a robust set of reporting guidelines, we propose a reporting framework consisting of eighteen reporting items under the following four domains: Context, Technology, Process and Metrics.
COVID-19 对全球医疗服务提出了医院容量方面的挑战，并使医护人员和弱势群体面临感染风险。面对这些挑战，许多医疗服务提供者已在患者家中实施了 COVID-19 远程患者监测 (RPM)。然而，对这些实施情况的文献进行系统回顾发现，RPM 的实施方式存在很大差异；同时，所报告的 RPM 具体细节也存在差异，这使得比较和评估变得困难。有必要对报告的项目进行审查，以制定一个关键项目框架，以提高报告的一致性。本次对 COVID-19 患者远程监测的综述有两个目的：(1) 通过在常见领域下制表来促进 RPM 实施之间的比较。(2) 制定一个报告框架，以提高报告的一致性。
按照 PRISMA 指南对 COVID-19 患者 RPM 的文献进行综述。检索了 2020 年至 2023 年 2 月期间发表的文章，纳入了对具有足够详细信息以进行比较的项目进行报告的研究。由主要作者提取和综合相关数据。由于考虑的文章被评估为临床实施的信息报告，而不是旨在回答研究问题的研究，因此未进行质量评估。
从 305 项研究中检索到 23 项研究被纳入综述：其中 14 项来自美国，2 项来自英国，1 项分别来自非洲、爱尔兰、中国、荷兰、比利时、澳大利亚和意大利。确定了 16 个一般报告项目，括号中显示了报告研究的百分比：报告期 (82%)、基本原理 (100%)、患者 (100%)、医疗团队 (91%)、提供者/基础设施 (91%)、通信平台 (100%)、患者设备 (100%)、培训 (48%)、标记物 (96%)、提示/输入频率 (96%)、阈值 (82%)、出院 (61%)、登记 (96%)、警报/升级 (78%)、患者接受度 (43%)和患者依从性 (52%)。虽然一些研究报告了患者培训和接受度，但只有一项研究报告了员工培训，没有研究报告员工接受度。
发现报告项目存在差异。在建立一套可靠的报告指南之前，我们提出了一个由以下四个领域下的 18 个报告项目组成的报告框架：背景、技术、流程和指标。
