TY - JOUR
T1 - Remote Patient Monitoring System for Polypathological Older Adults at High Risk for Hospitalization
T2 - Retrospective Cohort Study
AU - Testa, Damien
AU - Salma, Israa
AU - Iborra, Vincent
AU - Roussel, Victoire
AU - Dutech, Mireille
AU - Minvielle, Etienne
AU - Cabanes, Elise
N1 - Publisher Copyright:
© Damien Testa, Israa Salma, Vincent Iborra, Victoire Roussel, Mireille Dutech, Etienne Minvielle, Elise Cabanes.
PY - 2025/1/1
Y1 - 2025/1/1
N2 - Background: Health care systems are increasingly facing challenges posed by the aging of populations. In particular, hospitalization, both initial and subsequent, is often observed among older adult patients. However, research suggests that nearly 23% of all hospitalizations could be avoided. In this perspective, remote patient monitoring (RPM) systems are emerging as a promising solution, enabling professionals to detect and manage patient complexities early within home-based care settings. Objective: This study aims to provide additional analyses regarding the impact of the EPOCA RPM system for polypathological older adult patients on the total number of unplanned hospitalization days and admissions, as well as emergency department (ED) visits. In a prior study, we evaluated the impact when the operator of the RPM system is a geriatrician. In this study, we assess the impact when the general practitioner is the operator. Methods: We used a retrospective, before-and-after cohort design. Polypathological older adult patients aged 70 and older, who benefited from the EPOCA RPM system for at least 1 year (between February 2022 and August 2024), were included in the analysis. We compared the outcomes between the previous year (Y–1) and the follow-up year (Y) by the EPOCA RPM system. Statistical analyses were significant at P value <.05 Results: In total, 80 patients were included in the analysis, with an average age of 87. The results showed a significant reduction (P<.001) between Y–1 and Y in the total number of unplanned hospital admissions (by 57%), hospitalization days (by 49%), and ED visits (by 62%). Our findings reflected a significant decrease per patient from 0.99 to 0.42 in hospital admissions, from 0.99 to 0.37 in ED visits, and a reduction of 9.7 hospitalization days per year (P<.001). Additional analyses stratifying by hospitalization history, disability level, and caregiver status showed that the greatest effect of the RPM system was on patients with high risk and severe disability. Finally, there was no observed increase in mortality or transfers to intensive care units. Conclusions: Our findings are consistent with our previous results regarding the potential benefits of the EPOCA RPM system in managing care for polypathological older adult patients, this time with general practitioners as system operators. They also support existing evidence on the promise of RPM in improving care and health outcomes for older adult patients while alleviating hospital burdens by reducing unplanned hospitalizations and ED visits. It is, therefore, essential to incorporate reimbursement policies for these RPM initiatives so as to facilitate their adoption within health care systems and enhance their impact on health outcomes.
AB - Background: Health care systems are increasingly facing challenges posed by the aging of populations. In particular, hospitalization, both initial and subsequent, is often observed among older adult patients. However, research suggests that nearly 23% of all hospitalizations could be avoided. In this perspective, remote patient monitoring (RPM) systems are emerging as a promising solution, enabling professionals to detect and manage patient complexities early within home-based care settings. Objective: This study aims to provide additional analyses regarding the impact of the EPOCA RPM system for polypathological older adult patients on the total number of unplanned hospitalization days and admissions, as well as emergency department (ED) visits. In a prior study, we evaluated the impact when the operator of the RPM system is a geriatrician. In this study, we assess the impact when the general practitioner is the operator. Methods: We used a retrospective, before-and-after cohort design. Polypathological older adult patients aged 70 and older, who benefited from the EPOCA RPM system for at least 1 year (between February 2022 and August 2024), were included in the analysis. We compared the outcomes between the previous year (Y–1) and the follow-up year (Y) by the EPOCA RPM system. Statistical analyses were significant at P value <.05 Results: In total, 80 patients were included in the analysis, with an average age of 87. The results showed a significant reduction (P<.001) between Y–1 and Y in the total number of unplanned hospital admissions (by 57%), hospitalization days (by 49%), and ED visits (by 62%). Our findings reflected a significant decrease per patient from 0.99 to 0.42 in hospital admissions, from 0.99 to 0.37 in ED visits, and a reduction of 9.7 hospitalization days per year (P<.001). Additional analyses stratifying by hospitalization history, disability level, and caregiver status showed that the greatest effect of the RPM system was on patients with high risk and severe disability. Finally, there was no observed increase in mortality or transfers to intensive care units. Conclusions: Our findings are consistent with our previous results regarding the potential benefits of the EPOCA RPM system in managing care for polypathological older adult patients, this time with general practitioners as system operators. They also support existing evidence on the promise of RPM in improving care and health outcomes for older adult patients while alleviating hospital burdens by reducing unplanned hospitalizations and ED visits. It is, therefore, essential to incorporate reimbursement policies for these RPM initiatives so as to facilitate their adoption within health care systems and enhance their impact on health outcomes.
KW - chronically ill patients
KW - emergency department visits
KW - general practitioner
KW - geriatric care
KW - health care outcomes
KW - telemonitoring
KW - unplanned hospitalization
UR - https://www.scopus.com/pages/publications/105010589934
U2 - 10.2196/71527
DO - 10.2196/71527
M3 - Article
AN - SCOPUS:105010589934
SN - 1438-8871
VL - 27
JO - Journal of Medical Internet Research
JF - Journal of Medical Internet Research
M1 - e71527
ER -