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Observational Study
. 2023 Mar 20;59(3):617.
doi: 10.3390/medicina59030617.

Multimodal Remote Home Monitoring of Lung Transplant Recipients during COVID-19 Vaccinations: Usability Pilot Study of the COVIDA Desk Incorporating Wearable Devices

Macé M Schuurmans  1   2 , Michal Muszynski  3 , Xiang Li  4   5 , Ričards Marcinkevičs  5 , Lukas Zimmerli  3 , Diego Monserrat Lopez  3   6 , Bruno Michel  3 , Jonas Weiss  3 , René Hage  1   2 , Maurice Roeder  1   2 , Julia E Vogt  5 , Thomas Brunschwiler  3
Affiliations
Observational Study

Multimodal Remote Home Monitoring of Lung Transplant Recipients during COVID-19 Vaccinations: Usability Pilot Study of the COVIDA Desk Incorporating Wearable Devices

Macé M Schuurmans et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Remote patient monitoring (RPM) of vital signs and symptoms for lung transplant recipients (LTRs) has become increasingly relevant in many situations. Nevertheless, RPM research integrating multisensory home monitoring in LTRs is scarce. We developed a novel multisensory home monitoring device and tested it in the context of COVID-19 vaccinations. We hypothesize that multisensory RPM and smartphone-based questionnaire feedback on signs and symptoms will be well accepted among LTRs. To assess the usability and acceptability of a remote monitoring system consisting of wearable devices, including home spirometry and a smartphone-based questionnaire application for symptom and vital sign monitoring using wearable devices, during the first and second SARS-CoV-2 vaccination. Materials and Methods: Observational usability pilot study for six weeks of home monitoring with the COVIDA Desk for LTRs. During the first week after the vaccination, intensive monitoring was performed by recording data on physical activity, spirometry, temperature, pulse oximetry and self-reported symptoms, signs and additional measurements. During the subsequent days, the number of monitoring assessments was reduced. LTRs reported on their perceptions of the usability of the monitoring device through a purpose-designed questionnaire. Results: Ten LTRs planning to receive the first COVID-19 vaccinations were recruited. For the intensive monitoring study phase, LTRs recorded symptoms, signs and additional measurements. The most frequent adverse events reported were local pain, fatigue, sleep disturbance and headache. The duration of these symptoms was 5-8 days post-vaccination. Adherence to the main monitoring devices was high. LTRs rated usability as high. The majority were willing to continue monitoring. Conclusions: The COVIDA Desk showed favorable technical performance and was well accepted by the LTRs during the vaccination phase of the pandemic. The feasibility of the RPM system deployment was proven by the rapid recruitment uptake, technical performance (i.e., low number of errors), favorable user experience questionnaires and detailed individual user feedback.

Keywords: COVID-19 vaccination; chronic disease; digital health; disease management; home monitoring; lung transplant; patient monitoring; respiratory disease.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Daily measurement schedule during the intensive monitoring and reduced monitoring study periods. This figure was used to explain the study procedures to the patients and handed out as instructions for later reference (translated version since original was in German).
Figure 2
Figure 2
The COVIDA desk setup for the usability study contains a collection of sensors and monitoring modalities. Items in the picture are numbered and explained: (1) Wrist-worn accelerometer and heart rate sensor on magnetic charging interface; (2) finger ring pulse oximeter for continuous measurement of heart rate and oxygenation saturation; (3) infrared thermometer for forehead temperature measurement; (4) continuous core body temperature measurement device; (5) spirometer with mouthpiece for measurement of lung function; and (6) smartphone with daily questionnaire in the COVIDA app. The respective applications on the smartphone screen are indicated in brackets.
Figure 3
Figure 3
Adherence to monitoring modalities during intensive monitoring period for both vaccinations combined. The x-axis shows the different modalities studied while the y-axis shows box plots of adherence. PULSO: PULSOoximeter; CBTS: Core Body Temperature Sensor; ACT-TRACK: ACTivity-TRACKer; IRT: InfraRed Thermometer; INTENSIVE-SSQs: Intensive Symptom and Sign Questionnaires; SPIRO: SPIROmeter; BP: Blood Pressure; GLUC: GLUCOmeter.
Figure 4
Figure 4
Adherence to monitoring modalities heatmap for both monitoring periods combined (the 1st and 2nd vaccination) for the whole study population. Green-color fields indicate very high adherence, yellow fields indicate moderate adherence and brown fields indicate low adherence. On the x-axis, the days after vaccination are presented for intensive monitoring phase, i.e., the first 8 days, while the y-axis corresponds to modalities. Adherence to INTENSIVE-SSQs means that all questions were answered. Abbreviations: PULSO: PULSOoximeter; CBTS: Core Body Temperature Sensor; ACT-TRACK: ACTivity-TRACKer; IRT: InfraRed Thermometer; INTENSIVE-SSQs: Intensive Symptom and Sign Questionnaires; SPIRO: SPIROmeter; BP: Blood Pressure; GLUC: GLUCOmeter.
Figure 5
Figure 5
Symptom frequency purely based on whether the patients had the specific symptom during the two vaccination phases.
Figure 6
Figure 6
Symptom frequency for both monitoring periods of the 1st and 2nd vaccination combined. Symptom frequency for both monitoring periods is shown.
Figure 7
Figure 7
The duration of symptoms documented during the intensive monitoring phase is shown. Each data point represents a patient with the respective symptom indicating the duration of the symptom.
Figure 8
Figure 8
User experience questionnaire evaluation for selected questions. Red and orange colors indicate negative assessments, gray indicates neutral responses and green colors indicate favorable assessments, characterized by specific adjectives mentioned in the figure.
Figure 9
Figure 9
The effect size for the Wilcoxon signed-rank test between the intervention and control period for symptom-frequency-based biomarkers after the first or second vaccination.
Figure 10
Figure 10
The effect size for the Wilcoxon signed-rank test between the intervention and control period for symptom-intensity-based biomarkers after the first or second vaccination. CBT: Core Body Temperature Sensor.
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References

    1. Gholamzadeh M., Abtahi H., Safdari R. Telemedicine in lung transplant to improve patient-centered care: A systematic review. Int. J. Med. Inform. 2022;167:104861. doi: 10.1016/j.ijmedinf.2022.104861. - DOI - PubMed
    1. Blumenthal J.A., Smith P.J., Sherwood A., Mabe S., Snyder L., Frankel C., McKee D.C., Hamilton N., Keefe F.J., Shearer S., et al. Remote Therapy to Improve Outcomes in Lung Transplant Recipients: Design of the INSPIRE-III Randomized Clinical Trial. Transplant. Direct. 2020;6:e535. doi: 10.1097/TXD.0000000000000979. - DOI - PMC - PubMed
    1. Schenkel F.A., Barr M.L., McCloskey C.C., Possemato T., O’Conner J., Sadeghi R., Bembi M., Duong M., Patel J., Hackmann A.E., et al. Use of a Bluetooth tablet-based technology to improve outcomes in lung transplantation: A pilot study. Am. J. Transplant. 2020;20:3649–3657. doi: 10.1111/ajt.16154. - DOI - PMC - PubMed
    1. Mofaz M., Yechezkel M., Guan G., Brandeau M.L., Patalon T., Gazit S., Yamin D., Shmueli E. Self-Reported and Physiologic Reactions to Third BNT162b2 mRNA COVID-19 (Booster) Vaccine Dose. Emerg. Infect. Dis. 2022;28:1375–1383. doi: 10.3201/eid2807.212330. - DOI - PMC - PubMed
    1. Koc O.M., Pierco M., Remans K., Van den Hende T., Verbeek J., Van Malenstein H., Van der Merwe S., Robaeys G., Monbaliu D., Pirenne J., et al. Telemedicine based remote monitoring after liver transplantation: Feasible in a select group and a more stringent control of immunosuppression. Clin. Transplant. 2022;36:e14494. doi: 10.1111/ctr.14494. - DOI - PMC - PubMed

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Ričards Marcinkevičs is supported by the SNSF grant #320038189096. This research received no external funding.