TY - JOUR
T1 - Use of a Bluetooth tablet-based technology to improve outcomes in lung transplantation
T2 - A pilot study
AU - Schenkel, Felicia A.
AU - Barr, Mark L.
AU - McCloskey, Chris C.
AU - Possemato, Tammie
AU - O'Conner, Jeremy
AU - Sadeghi, Roya
AU - Bembi, Maria
AU - Duong, Marian
AU - Patel, Jaynita
AU - Hackmann, Amy E.
AU - Ganesh, Sivagini
N1 - Funding Information:
This work was supported by funding from the USC Transplant Institute at the Keck Hospital of University of Southern California.
Publisher Copyright:
© 2020 The Authors. American Journal of Transplantation published by Wiley Periodicals LLC on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons
PY - 2020/12
Y1 - 2020/12
N2 - The impact of remote patient monitoring platforms to support the postoperative care of solid organ transplant recipients is evolving. In an observational pilot study, 28 lung transplant recipients were enrolled in a novel postdischarge home monitoring program and compared to 28 matched controls during a 2-year period. Primary endpoints included hospital readmissions and total days readmitted. Secondary endpoints were survival and inflation-adjusted hospital readmission charges. In univariate analyses, monitoring was associated with reduced readmissions (incidence rate ratio [IRR]: 0.56; 95% confidence interval [CI]: 0.41-0.76; P <.001), days readmitted (IRR: 0.46; 95% CI: 0.42-0.51; P <.001), and hospital charges (IRR: 0.52; 95% CI: 0.51-0.54; P <.001). Multivariate analyses also showed that remote monitoring was associated with lower incidence of readmission (IRR: 0.38; 95% CI: 0.23-0.63; P <.001), days readmitted (IRR: 0.14; 95% CI: 0.05-0.37; P <.001), and readmission charges (IRR: 0.11; 95% CI: 0.03-0.46; P =.002). There were 2 deaths among monitored patients compared to 6 for controls; however, this difference was not significant. This pilot study in lung transplant recipients suggests that supplementing postdischarge care with remote monitoring may be useful in preventing readmissions, reducing subsequent inpatient days, and controlling hospital charges. A multicenter, randomized control trial should be conducted to validate these findings.
AB - The impact of remote patient monitoring platforms to support the postoperative care of solid organ transplant recipients is evolving. In an observational pilot study, 28 lung transplant recipients were enrolled in a novel postdischarge home monitoring program and compared to 28 matched controls during a 2-year period. Primary endpoints included hospital readmissions and total days readmitted. Secondary endpoints were survival and inflation-adjusted hospital readmission charges. In univariate analyses, monitoring was associated with reduced readmissions (incidence rate ratio [IRR]: 0.56; 95% confidence interval [CI]: 0.41-0.76; P <.001), days readmitted (IRR: 0.46; 95% CI: 0.42-0.51; P <.001), and hospital charges (IRR: 0.52; 95% CI: 0.51-0.54; P <.001). Multivariate analyses also showed that remote monitoring was associated with lower incidence of readmission (IRR: 0.38; 95% CI: 0.23-0.63; P <.001), days readmitted (IRR: 0.14; 95% CI: 0.05-0.37; P <.001), and readmission charges (IRR: 0.11; 95% CI: 0.03-0.46; P =.002). There were 2 deaths among monitored patients compared to 6 for controls; however, this difference was not significant. This pilot study in lung transplant recipients suggests that supplementing postdischarge care with remote monitoring may be useful in preventing readmissions, reducing subsequent inpatient days, and controlling hospital charges. A multicenter, randomized control trial should be conducted to validate these findings.
KW - business/management
KW - clinical research/practice
KW - economics
KW - health services and outcomes research
KW - hospital readmission
KW - lung transplantation/pulmonology
KW - monitoring: physiologic
KW - organ transplantation in general
KW - outpatient care
KW - quality of care/care delivery
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U2 - 10.1111/ajt.16154
DO - 10.1111/ajt.16154
M3 - Article
C2 - 32558226
AN - SCOPUS:85087751565
SN - 1600-6135
VL - 20
SP - 3649
EP - 3657
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 12
ER -