TY - JOUR
AU - Shah, Shimul A.
AB - Objective: This study assesses the impact of a telemedicine-based home management program (THMP) on patient adherence, hospital readmissions, and quality of life (QOL) after liver transplantation (LT). Summary of Background Data: Telemedicine interventions represent an opportunity to personalize care and can lead to improved adherence and patient satisfaction. However, there is limited data on impact of these interventions on outcomes after LT. Therefore, we conducted the first randomized controlled trial (RCT) of a THMP compared to standard of care (SOC) after LT. Methods: One hundred six consecutive LT recipients were randomized (1:1) to 1 of 2 posttransplant care strategies: SOC or THMP. The THMP included an electronic tablet and bluetooth devices to support daily text messages, education videos, and video FaceTime capability; data was cyber-delivered into our electronic medical record daily. Endpoints were THMP participation, 90-day hospital readmission rate, and QOL. Results: One hundred patients completed the study with 50 enrolled in each arm. Participation and adherence with telemedicine was 86% for basic health sessions (vital sign recording), but only 45% for using messaging or FaceTime. The THMP group had a lower 90-day readmission rate compared to SOC (28% vs 58%; P = 0.004). The THMP cohort also showed improved QOL in regards to physical function (P = 0.02) and general health (P = 0.05) at 90 days. Conclusions: To our knowledge, this is the first RCT demonstrating the impact of THMP after LT. The magnitude of effect on LT outcomes, hospital readmissions, and QOL suggests that the adoption of telemedicine has great potential for other major operations. Cincinnati Research on Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH. shahsu@ucmail.uc.edu. Grants and financial support: University of Cincinnati Comparative Effectiveness and Patient Centered Outcomes Grant and Care Innovations, LLC. This paper was presented at the 139th American Surgical Association Annual Meeting in Dallas, TX on April 12, 2019. The author reports no conflicts of interest.
TI - Telemedicine Based Remote Home Monitoring After Liver Transplantation: Results of a Randomized Prospective Trial
JO - Annals of Surgery
DO - 10.1097/SLA.0000000000003425
DA - 2019-09-01
UR - https://www.deepdyve.com/lp/wolters-kluwer-health/telemedicine-based-remote-home-monitoring-after-liver-transplantation-oj7GfxP4NT
SP - 564
VL - 270
IS - 3
DP - DeepDyve
ER -