Tan Si Ying, Sumner Jennifer, Wang Yuchen, Wenjun Yip Alexander
Alexandra Research Centre for Healthcare In The Virtual Environment (ARCHIVE), Alexandra Hospital, National University Health System, Singapore, Singapore.
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
NPJ Digit Med. 2024 Jul 18;7(1):192. doi: 10.1038/s41746-024-01182-w.
Due to rapid technological advancements, remote patient monitoring (RPM) technology has gained traction in recent years. While the effects of specific RPM interventions are known, few published reviews examine RPM in the context of care transitions from an inpatient hospital setting to a home environment. In this systematic review, we addressed this gap by examining the impacts of RPM interventions on patient safety, adherence, clinical and quality of life outcomes and cost-related outcomes during care transition from inpatient care to a home setting. We searched five academic databases (PubMed, CINAHL, PsycINFO, Embase and SCOPUS), screened 2606 articles, and included 29 studies from 16 countries. These studies examined seven types of RPM interventions (communication tools, computer-based systems, smartphone applications, web portals, augmented clinical devices with monitoring capabilities, wearables and standard clinical tools for intermittent monitoring). RPM interventions demonstrated positive outcomes in patient safety and adherence. RPM interventions also improved patients' mobility and functional statuses, but the impact on other clinical and quality-of-life measures, such as physical and mental health symptoms, remains inconclusive. In terms of cost-related outcomes, there was a clear downward trend in the risks of hospital admission/readmission, length of stay, number of outpatient visits and non-hospitalisation costs. Future research should explore whether incorporating intervention components with a strong human element alongside the deployment of technology enhances the effectiveness of RPM. The review highlights the need for more economic evaluations and implementation studies that shed light on the facilitators and barriers to adopting RPM interventions in different care settings.
由于技术的快速进步,远程患者监测(RPM)技术近年来越来越受到关注。虽然特定RPM干预措施的效果是已知的,但很少有已发表的综述在从住院医院环境到家庭环境的护理过渡背景下研究RPM。在这项系统综述中,我们通过研究RPM干预措施在从住院护理到家庭环境的护理过渡期间对患者安全、依从性、临床和生活质量结果以及成本相关结果的影响,填补了这一空白。我们检索了五个学术数据库(PubMed、CINAHL、PsycINFO、Embase和SCOPUS),筛选了2606篇文章,并纳入了来自16个国家的29项研究。这些研究考察了七种类型的RPM干预措施(通信工具、基于计算机的系统、智能手机应用程序、门户网站、具有监测功能的增强型临床设备、可穿戴设备以及用于间歇性监测的标准临床工具)。RPM干预措施在患者安全和依从性方面显示出积极结果。RPM干预措施还改善了患者的移动性和功能状态,但对其他临床和生活质量指标(如身心健康症状)的影响仍不确定。在成本相关结果方面,住院/再入院风险、住院时间、门诊就诊次数和非住院费用有明显下降趋势。未来的研究应探索在技术部署的同时纳入具有强大人文因素的干预成分是否能提高RPM的有效性。该综述强调需要进行更多的经济评估和实施研究,以阐明在不同护理环境中采用RPM干预措施的促进因素和障碍。