First real-world experience with mobile health telemonitoring in adult patients with congenital heart disease.

BACKGROUND: Arrhythmias and heart failure are common and invalidating sequelae in adult patients with congenital heart disease (CHD). Mobile health (m-Health) enables daily monitoring and a timely response that might prevent deterioration. We present an observational prospective registry to evaluate feasibility of an m­Health telemonitoring program for managing arrhythmia, heart failure and blood pressure in symptomatic adults with CHD. METHODS: Symptomatic adult patients with CHD are enrolled in an m­Health telemonitoring program, which evaluates single-lead ECG, blood pressure and weight measurements. In case of symptoms extra measurements could be performed. Data are collected by mobile apps, matched with individualised thresholds. Patients are contacted if thresholds were exceeded or if arrhythmias were found, for treatment adjustments or reassurance. Data on emergency care utilisation, hospitalisation and patient-reported outcome measures are used to assess quality of life and self-management. RESULTS: 129 symptomatic CHD patients were invited to participate, 55 participated. Reasons for refusing consent included too time consuming to participate in research (30) and to monitor vital signs (14). At baseline 22 patients were in New York Heart Association class ≥ II heart failure, 43 patients had palpitations or documented arrhythmias, and 8 had hypertension. Mean follow-up was 3.0 months, one patient dropped out, and adherence was 97%. CONCLUSION: The first results indicate that this program is feasible with high adherence.

[Dementia and technology. A study of technology interventions in the healthcare for dementia patients and their caregivers]. / Dementie en technologie. Een studie naar de toepassingen van techniek in de zorg voor mensen met dementie en hun mantelzorgers.

PURPOSE: To explore the possibilities for IT interventions in care of older persons with dementia. METHOD: Inventory of international and national studies on implemented technology interventions for the care of persons with dementia and their caregivers. Three categories of technology are distinguished: (1) help with symptoms of dementia (2) social contact and company for the patient, and (3) health monitoring and safety. RESULTS: Eighteen international and eight national studies are included. The first results of the effects of technology interventions for patients with dementia look promising. Evidence exists for significant improvements as to the quality of life and effects on behaviour (such as less falling). The caregivers and healthcare professionals are satisfied with the usability of the technology. The purchase and user costs, however, are often too high. The labour satisfaction of healthcare professionals in relation to the use of technology has rarely been studied. CONCLUSION: Although technology can improve the ability to cope with certain consequences of dementia, the effects of technology for dementia patients, caregivers and healthcare professionals has not yet been extensively studied. Further research may focus on effects of technology for people with dementia and their caregivers as to their quality of life, feeling of safety and work satisfaction, respectively.