Remote patient monitoring in patients with COVID-19 at home: literature review.

Remote patient monitoring in patients with COVID-19 at home: literature review.

Publication date: Sep 13, 2024

During the pandemic healthcare providers implemented remote patient monitoring (RPM) for patients suffering from COVID-19. RPM is an interaction between healthcare professionals and patients who are in different locations, in which a certain number of patient’s functioning parameters is assessed and followed up for a certain duration of time. By implementing RPM for these patients they obtained to reduce the strain on hospitals and primary care. With this literature review we aim at describing the characteristics of the RPM interventions, reporting on the patients with COVID-19 included in RPM, and providing an overview of outcome variables such as length of stay (LOS), hospital (re)admissions, and mortality. A combination of different searches in several database types (traditional databases, trial registers, daily (google) searches and daily Pubmed alerts) were run daily from March 2020 till December 2021. A search update for randomized clinical trials (RCT’s) was done in April 2022. The initial search yielded more than 4448 articles (not including daily searches). After deduplication and assessment for eligibility, 241 articles were retained describing 164 telemonitoring studies from 160 centres. None of the 164 studies covering 248,431 included patients reported on the presence of a randomized control group. Studies described a ‘prehosp’ group (96 studies) with patients who had a suspected or confirmed COVID-19 diagnosis and for whom it was decided not to hospitalize them yet, but closely monitor them at home, or a ‘posthosp’ group (32 studies) with patients who were monitored at home after hospitalization for COVID-19; 34 studies described both groups, in 2 studies it was unclear. There is a large variety in number of emergency department (ED) visits (0-36% and 0-16%) and no convincing evidence that RPM leads to less or more ED-visits as well as hospital (re)admissions (0-30% and 0-22%) in prehosp and posthosp, respectively. Mortality was generally low, and there is weak to no evidence that RPM is associated with lower mortality. There is neither evidence that RPM shortens previous LOS. A literature update detected three small scale RCT’s which could not demonstrate statistically significant differences in these outcomes. Most papers claim savings, however the scientific base for these claims is doubtful. The overall patient experiences with RPM were positive, as patients felt more reassured, although many patients declined RPM for several reasons (eg, technological embarrassment, digital literacy, etc. ). Based on these results, there is no convincing evidence that RPM in COVID-19 patients could avoid ED-visits or hospital (re)admissions, could shorten LOS or reduce mortality, but neither is there evidence that RPM has adverse outcomes. Further research should focus on developing, implementing, and evaluating an RPM framework.

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Concepts Keywords
Base Covid
December Daily
Google Ed
Hospitalization Evidence
Group
Home
Hospital
Los
Mortality
Patient
Readmissions
Remote
Rpm
Searches
Visits

Semantics

Type Source Name
disease MESH COVID-19
disease MESH emergency
drug DRUGBANK Coenzyme M
disease MESH infection
disease IDO blood
drug DRUGBANK Oxygen
drug DRUGBANK Acetaminophen
disease IDO intervention
disease MESH uncertainty
disease IDO process
disease IDO country
disease MESH comorbidity
drug DRUGBANK Etoperidone
disease MESH dyspnea
drug DRUGBANK Hydroxychloroquine
drug DRUGBANK Lopinavir
drug DRUGBANK Ritonavir

Original Article

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