296 research outputs found

    Technology-driven heart failure management system : changes in functional capacity and quality of life.

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    Background . Heart failure treatment guidelines emphasize the importance of daily weight monitoring. To support this practice, the Health Care Financing Administration Heart Failure Demonstration Project (2000) was designed to evaluate the effect of technology driven monitoring of daily weight and symptoms in elderly HF patients (NYHA class II to IV). This sub-study is conducted to assess the effect of a technology driven HF monitoring system on clinically meaningful change in functional capacity and quality of life (QOL). Methods . This is a randomized, multi-centered, controlled clinical trial in which Medicare beneficiaries with a history of hospitalization within one year were randomized to standard care or standard care + a technology driven heart failure monitoring system. Primary end points were clinically meaningful change in functional capacity [6-minute walk distance (6MWD) or 6-minute work (6MW)] and QOL [Minnesota Living with Heart Failure Questionnaire (MLHF)] after 6-months of follow-up. Regression to the mean effects were estimated and adjusted according to the Edwards-Nunnally (EN) method. Clinically meaningful change is then defined in terms of the standard error of measurement (SEM) criterion. Results . Two hundred eighty four patients from three centers in USA were randomized. Mean age was 74 +/- 9 yrs, 58% were male, 82% were Caucasians, and New York Heart Association class II (31%), III (59%), and IV (10%). The change in functional capacity in terms of 6WD was 42 m, by 6MW was 3668 kg/m of work, and change in QOL in terms of MLHF total score by 6.0, physical dimension score by 4.0, and emotional dimension score by 2.0 from baseline. Body mass index, Left ventricular Ejection Fraction, beta-blocker usage and intra-cardiac device (ICD) implantation were the best clinically relevant predictors of change in functional capacity. Technology driven heart failure management did not result in a clinically meaningful incremental benefit in functional capacity or in QOL. Conclusions . There is no significant clinically meaningful benefit in functional capacity or in QOL from technology driven HF monitoring system in NYHA class II-IV elderly HF patients. Further, monitoring HF patients increased outpatient care resource utilization and costs, and was associated with a significantly poorer QOL

    The rise of consumer health wearables: promises and barriers

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    Will consumer wearable technology ever be adopted or accepted by the medical community? Patients and practitioners regularly use digital technology (e.g., thermometers and glucose monitors) to identify and discuss symptoms. In addition, a third of general practitioners in the United Kingdom report that patients arrive with suggestions for treatment based on online search results. However, consumer health wearables are predicted to become the next “Dr Google.” One in six (15%) consumers in the United States currently uses wearable technology, including smartwatches or fitness bands. While 19 million fitness devices are likely to be sold this year, that number is predicted to grow to 110 million in 2018. As the line between consumer health wearables and medical devices begins to blur, it is now possible for a single wearable device to monitor a range of medical risk factors. Potentially, these devices could give patients direct access to personal analytics that can contribute to their health, facilitate preventive care, and aid in the management of ongoing illness. However, how this new wearable technology might best serve medicine remains unclea

    Strategic Intelligence Monitor on Personal Health Systems (SIMPHS): Market Structure and Innovation Dynamics

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    Personal Health Systems (PHS) and Remote Patient Monitoring and Treatment (RMT) have the potential to alter the way healthcare is provided by increasing the quantity and quality of care. This report explores the current status of PHS and, more specifically of the RMT market in Europe. It addresses the question of how these technologies can contribute facing some of the challenges standing in front of the European healthcare delivery systems causes by higher demand pressures through chronic diseases and demographic change combined with diminishing resources for health care. An uptake and diffusion of these services would potentially lead to benefits through a reduction in death rates, and avoid recurring hospitalisation in a cost-effective manner. Yet the report identifies different categories of barriers hampering a full deployment of RMT in Europe. In the concluding part the reports provides a number of tentative policy options specifically aimed at fostering EU-wide deployment of RMT/PHS.JRC.DDG.J.4-Information Societ

    Use of Telemedicine Healthcare Systems in Children and Adolescents with Chronic Disease or in Transition Stages of Life: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP) and of the Syndicate of Family Pediatrician Doctors (SIMPeF)

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    Telemedicine is considered an excellent tool to support the daily and traditional practice of the health profession, especially when referring to the care and management of chronic patients. In a panorama in which chronic pathologies with childhood onset are constantly increasing and the improvement of treatments has allowed survival for them into adulthood, telemedicine and remote assistance are today considered effective and convenient solutions both for the chronic patient, who thus receives personalized and timely assistance, and for the doctors, who reduce the need for direct intervention, hospitalizations and consequent management costs. This Consensus document, written by the main Italian Scientific Societies involved in the use of telemedicine in pediatrics, has the objectives to propose an organizational model based on the relationships between the actors who participate in the provision of a telemedicine service aimed at minors with chronic pathologies, identifying specific project links between the areas of telemedicine in the developmental age from the first 1000 days of life to the age adult. The future scenario will have to be able to integrate digital innovation in order to offer the best care to patients and citizens. It will have to be able to provide the involvement of patients from the very beginning of the design of any care pathway, increasing where possible the proximity of the health service to citizens

    Use of Telemedicine Healthcare Systems in Children and Adolescents with Chronic Disease or in Transition Stages of Life: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP) and of the Syndicate of Family Pediatrician Doctors (SIMPeF)

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    : Telemedicine is considered an excellent tool to support the daily and traditional practice of the health profession, especially when referring to the care and management of chronic patients. In a panorama in which chronic pathologies with childhood onset are constantly increasing and the improvement of treatments has allowed survival for them into adulthood, telemedicine and remote assistance are today considered effective and convenient solutions both for the chronic patient, who thus receives personalized and timely assistance, and for the doctors, who reduce the need for direct intervention, hospitalizations and consequent management costs. This Consensus document, written by the main Italian Scientific Societies involved in the use of telemedicine in pediatrics, has the objectives to propose an organizational model based on the relationships between the actors who participate in the provision of a telemedicine service aimed at minors with chronic pathologies, identifying specific project links between the areas of telemedicine in the developmental age from the first 1000 days of life to the age adult. The future scenario will have to be able to integrate digital innovation in order to offer the best care to patients and citizens. It will have to be able to provide the involvement of patients from the very beginning of the design of any care pathway, increasing where possible the proximity of the health service to citizens

    Telemonitoring of the Pacemakers

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    Effects of Supervised Exercise-based Telerehabilitation on Walk Test Performance and Quality of Life in Patients in India with Chronic Disease: Combatting COVID-19

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    Background: The world is currently undergoing a pandemic, caused by the SARS-CoV-2 virus (COVID-19). According to the World Health Organization, patients with chronic illnesses appear to be at the highest risk for COVID-19 associated sequelae. Inability to participate in outpatient-based rehabilitation programs and being home-bound can increase the risk for and potential worsening of chronic health conditions. This study evaluated the short-term effects of telerehabilitation on patients’ walk test performance and health related quality of life (HRQoL).  Methods: 47 patients (23 cardiovascular, 15 pulmonary, 9 oncology) participated in the telerehabilitation program. At baseline and following a 1-month intervention, patients had their 6-minute walk test distance (6MWTD) and HRQoL assessed. Average daily step counts were measured by the PACER App. Conclusion: Our results indicate that a short-term, supervised virtual telerehabilitation program had significant positive effects on 6MWTD and HRQoL in cardiac, pulmonary and oncology patients during COVID-19

    Effective implementation and monitoring of telehealth and telecare in Ireland: learning from international best practice.

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    This document synthesises the information provided in a number of papers relating to Telecare/Telehealth commissioned by and developed for the National Disability Authority between 2014 and 2017. The papers in question were developed by researchers in Work Research Centre (WRC), the National Disability Authority and the University of Ulster, and this report has taken key learning and information from each of them to create this composite briefing paper
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