卒中后远程患者血压监测是可行的,可以促进护理分诊。

Telemedicine reports Pub Date : 2022-08-02 eCollection Date: 2022-01-01 DOI:10.1089/tmr.2022.0004
Jenna M Tosto-Mancuso, David Putrino, Jamie Wood, Laura Tabacof, Erica Breyman, Leila Nasr, Nicki Mohammadi, Neha S Dangayach, Christopher P Kellner
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引用次数: 0

摘要

背景和目的:严格控制血压(BP)是一种普遍接受的预防继发性卒中的治疗干预措施,但当患者受伤后返回家中时,这仍然很困难。本研究旨在探讨远程患者监测(RPM)在脑卒中后或立即有脑卒中风险的患者中的应用,以及与分诊和护理升级相关的后续结果。方法:这是一项单中心概念验证研究。参与者是18岁及以上被诊断为中风或有立即中风风险的患者。患者被纳入精确恢复计划(PRP),并被要求每天评估他们的血压和心率,并在MyCap应用程序中输入RPM程序的值。这些数据每天由指定的PRP临床医生审查,每周与患者举行Zoom会议。护理经过分类,并根据指示升级到医生。结果:12例患者(5例[42%]女性,平均年龄[范围]63[43-84]岁)符合纳入标准,中位(范围)136(8-227)天。每位参与者血压超过限制的中位数(范围)为收缩压19(0-79),舒张压36(0-104)。共启动了16个分诊事件(中位数[范围]1[0-3]),以提高护理水平。结论:本研究表明,在卒中后或有卒中即刻风险的患者中,RPM是可行的,并且有助于在血压高于推荐限值时进行护理分诊。
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Remote Patient Monitoring of Blood Pressure Is Feasible Poststroke and Can Facilitate Triage of Care.

Background and purpose: Strict blood pressure (BP) control is a universally accepted therapeutic intervention in the prevention of secondary stroke, yet this remains difficult when patients return home postinjury. This study aimed to investigate the application of the remote patient monitoring (RPM) of BP in patients after stroke, or who were at immediate risk of stroke, and the subsequent outcomes relating to triage and escalation of care.

Methods: This was a single-center proof-of-concept study. Participants were patients aged 18 years and older with a diagnosis of stroke or who were at immediate risk of stroke. Patients were enrolled into the precision recovery program (PRP) and asked to assess their BP and heart rate daily and enter values into a MyCap application for the RPM program. These data were reviewed daily by an assigned PRP clinician, and weekly Zoom meetings were held with the patient. Care was triaged and escalated to a physician as indicated.

Results: Twelve patients (5 [42%] female, aged mean [range] 63 [43-84] years) met the inclusion criteria and continued in the program for median (range) 136 (8-227) days. The median (range) number of excursions of BP above limits per participant was 19 (0-79) for systolic and 36 (0-104) for diastolic. A total of 16 triage events (median [range] 1 [0-3]) were initiated for escalation of care.

Conclusions: This study demonstrated that RPM is feasible in patients poststroke or at immediate risk of stroke, and facilitates the triage of care when BP is elevated above recommended limits.

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