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Telemonitoring of Patients With Chronic Traumatic Brain Injury: A Pilot Study

Telehealth systems have shown success in the remote management of several neurological disorders, but there is a paucity of evidence in disorders of consciousness (DOC). In this study, we explore the effectiveness of a new telemonitoring system, for monitoring Vegetative State (VS) and Minimally Con...

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Autores principales: Raso, Maria Girolama, Arcuri, Francesco, Liperoti, Stefano, Mercurio, Luca, Mauro, Aldo, Cusato, Francesco, Romania, Lidia, Serra, Sebastiano, Pignolo, Loris, Tonin, Paolo, Cerasa, Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8047126/
https://www.ncbi.nlm.nih.gov/pubmed/33868141
http://dx.doi.org/10.3389/fneur.2021.598777
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author Raso, Maria Girolama
Arcuri, Francesco
Liperoti, Stefano
Mercurio, Luca
Mauro, Aldo
Cusato, Francesco
Romania, Lidia
Serra, Sebastiano
Pignolo, Loris
Tonin, Paolo
Cerasa, Antonio
author_facet Raso, Maria Girolama
Arcuri, Francesco
Liperoti, Stefano
Mercurio, Luca
Mauro, Aldo
Cusato, Francesco
Romania, Lidia
Serra, Sebastiano
Pignolo, Loris
Tonin, Paolo
Cerasa, Antonio
author_sort Raso, Maria Girolama
collection PubMed
description Telehealth systems have shown success in the remote management of several neurological disorders, but there is a paucity of evidence in disorders of consciousness (DOC). In this study, we explore the effectiveness of a new telemonitoring system, for monitoring Vegetative State (VS) and Minimally Conscious State (MCS) patients. This was a prospective, mono-center randomized controlled study. We included only traumatic brain injury (TBI) patients who required long-term motor/cognitive assistance having a stable clinical condition. We examined their clinical evolution over ~4 years of the follow-up period. Twenty-two TBI patients were enrolled and equally divided into two groups: one telemonitored at home with our service and the second admitted to a standard long-stay hospitalization (LSH) program. Patients enrolled in the telehealth service (age: 49.9 ± 20.4; 45% female; diagnosis: 36% VS/64% MCS) were demographically and clinically-matched with those admitted to the LSH program (age: 55.1 ± 15; 18% female; diagnosis: 54% VS/46% MCS). Thirty-six percent of patients in the LSH program died before completing follow up evaluation with respect to 18% of death in the group of TBI patients telemonitored at home. At follow-up, patients in LSH and telemonitoring groups showed similar clinical progression, as measured by CRS-r, NCS, WHIM, and LCF scales, as well as by the number of medical complications (i.e., bedsores, infections). Finally, we estimated the total daily cost per patient. Severe TBI patients enrolled in the conventional LSH program cost 262€ every single day, whereas the cost per patient in the telehealth service resulted to be less expensive (93€). Here, we highlight that our telehealth monitoring service is as efficacious as in-person usual care to manage a severe neurological disorder such as TBI in a cost-effective way.
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spelling pubmed-80471262021-04-16 Telemonitoring of Patients With Chronic Traumatic Brain Injury: A Pilot Study Raso, Maria Girolama Arcuri, Francesco Liperoti, Stefano Mercurio, Luca Mauro, Aldo Cusato, Francesco Romania, Lidia Serra, Sebastiano Pignolo, Loris Tonin, Paolo Cerasa, Antonio Front Neurol Neurology Telehealth systems have shown success in the remote management of several neurological disorders, but there is a paucity of evidence in disorders of consciousness (DOC). In this study, we explore the effectiveness of a new telemonitoring system, for monitoring Vegetative State (VS) and Minimally Conscious State (MCS) patients. This was a prospective, mono-center randomized controlled study. We included only traumatic brain injury (TBI) patients who required long-term motor/cognitive assistance having a stable clinical condition. We examined their clinical evolution over ~4 years of the follow-up period. Twenty-two TBI patients were enrolled and equally divided into two groups: one telemonitored at home with our service and the second admitted to a standard long-stay hospitalization (LSH) program. Patients enrolled in the telehealth service (age: 49.9 ± 20.4; 45% female; diagnosis: 36% VS/64% MCS) were demographically and clinically-matched with those admitted to the LSH program (age: 55.1 ± 15; 18% female; diagnosis: 54% VS/46% MCS). Thirty-six percent of patients in the LSH program died before completing follow up evaluation with respect to 18% of death in the group of TBI patients telemonitored at home. At follow-up, patients in LSH and telemonitoring groups showed similar clinical progression, as measured by CRS-r, NCS, WHIM, and LCF scales, as well as by the number of medical complications (i.e., bedsores, infections). Finally, we estimated the total daily cost per patient. Severe TBI patients enrolled in the conventional LSH program cost 262€ every single day, whereas the cost per patient in the telehealth service resulted to be less expensive (93€). Here, we highlight that our telehealth monitoring service is as efficacious as in-person usual care to manage a severe neurological disorder such as TBI in a cost-effective way. Frontiers Media S.A. 2021-04-01 /pmc/articles/PMC8047126/ /pubmed/33868141 http://dx.doi.org/10.3389/fneur.2021.598777 Text en Copyright © 2021 Raso, Arcuri, Liperoti, Mercurio, Mauro, Cusato, Romania, Serra, Pignolo, Tonin and Cerasa. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Raso, Maria Girolama
Arcuri, Francesco
Liperoti, Stefano
Mercurio, Luca
Mauro, Aldo
Cusato, Francesco
Romania, Lidia
Serra, Sebastiano
Pignolo, Loris
Tonin, Paolo
Cerasa, Antonio
Telemonitoring of Patients With Chronic Traumatic Brain Injury: A Pilot Study
title Telemonitoring of Patients With Chronic Traumatic Brain Injury: A Pilot Study
title_full Telemonitoring of Patients With Chronic Traumatic Brain Injury: A Pilot Study
title_fullStr Telemonitoring of Patients With Chronic Traumatic Brain Injury: A Pilot Study
title_full_unstemmed Telemonitoring of Patients With Chronic Traumatic Brain Injury: A Pilot Study
title_short Telemonitoring of Patients With Chronic Traumatic Brain Injury: A Pilot Study
title_sort telemonitoring of patients with chronic traumatic brain injury: a pilot study
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8047126/
https://www.ncbi.nlm.nih.gov/pubmed/33868141
http://dx.doi.org/10.3389/fneur.2021.598777
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