A Feasibility and Pilot Randomized Clinical Trial Assessing the Integration of Digital Remote Patient Monitoring Within Pulmonary Rehabilitation
Notice bibliographique
Résumé
Abstract Rationale: Chronic respiratory diseases, like chronic obstructive pulmonary disease (COPD), require self-monitoring and disease management, yet traditional methods are hindered by cognitive decline, low health literacy, and symptom underreporting. Pulmonary rehabilitation (PR) improves outcomes but has diminishing long-term effects. Integrating digital remote patient monitoring (DRPM) into PR permits continuous symptom tracking and early exacerbation detection and may facilitate better adherence to disease management behaviours. This study evaluated the feasibility of combining PR with DRPM and will inform future trials assessing clinical efficacy. Methods: Participants in this cluster-randomized trial were assigned to Standard-PR or PR+DRPM, with both groups completing 16 PR sessions over 6 or 8 weeks, then a 12-week post-PR follow-up. Using a Wi-Fi-enabled, Bluetooth-connected device, the PR+DRPM group monitored five resting vital signs daily – blood pressure, heart rate, oxygen saturation, body temperature and weight. Daily adherence was tracked automatically via device connectivity, with missed readings prompting compliance calls. DRPM data were linked to the patient's electronic health record. PR providers monitored the data remotely and contacted participants if readings exceeded pre-set thresholds. Feasibility outcomes included recruitment, retention, adherence, acceptability, adverse events, and staff workload. Secondary outcomes (exercise capacity, quality of life, physical activity and self-efficacy) were analyzed using linear mixed models. Results: The recruitment rate was 94% (n=78, 55% male, mean age = 68.4 ± 11, mean FEV1 = 59.1 ± 22.7). Retention was 77% post-PR and 67% at 12-week follow-up, with similar rates between groups. 94% of PR+DRPM participants attended all PR sessions compared to 86% in Standard-PR. Participants’ adherence to daily vitals monitoring was 90% during PR and 89% at follow-up; 163 compliance calls were made when readings were missed. 100% of participants would recommend DRPM to other patients, and 92% agreed that their health information was kept private. Ten participants reported minor and transient adverse events not related to DRPM. Staff workload increased by ∼45 minutes per participant (attending 496 notifications for abnormal data) over the trial. Secondary outcomes did not differ between the two groups. Conclusion: PR+DRPM is feasible and well-received by participants based on high adherence to daily readings. However, the high number of compliance calls to address missed readings suggests that DRPM may significantly burden staff. Addressing staff workload will be essential in planning a larger trial to examine the efficacy, cost-effectiveness, and scalability of DRPM for sustainable use in managing COPD and other chronic respiratory diseases.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,007 | 0,009 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,002 |
| Communication savante | 0,001 | 0,002 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».