Cancer Management and Research (May 2022)
Management of Treatment-Related Infectious Complications in High-Risk Hemato-Oncological Patients via Telemedicine
Abstract
Katarína Hradská,1,2 Tereza Popková,1,2 Michaela Skořupová,1,2 Jana Mihályová,2 Tomáš Jelínek,2 Jana Lančová,3 Norbert Schellong,3 Roman Hájek1,2 1Faculty of Science, University of Ostrava, Ostrava, Czech Republic; 2Department of Haematooncology, University Hospital Ostrava and Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic; 3National Monitoring Center, Ostrava, Czech RepublicCorrespondence: Katarína Hradská, Department of Haematooncology, University Hospital Ostrava and Faculty of Medicine, University of Ostrava, 17. listopadu 1790, Ostrava, 70852, Czech Republic, Tel +420 597 37 2092, Fax +420 597 37 2092, Email [email protected]: Infectious complications, especially febrile neutropenia, in hemato-oncological patients are associated with considerable morbidity, mortality and expenses. Remote monitoring of physiological functions and thus early detection of adverse events via telemedicine could improve the safety of these high-risk patients and save financial resources by shortening the time-to-antibiotics.Methods: Patients undergoing active cancer treatment in high risk of acquiring severe infection are selected and enrolled in this project. Each patient receives a digital blood pressure monitor, an infrared thermometer and a mobile hub (cell phone). In the comfort of their homes, patients measure their blood pressure/pulse and body temperature regularly or whenever they feel unwell. The obtained data are encrypted and forwarded via the mobile hub to the password-protected portal. The values registered outside the set-up range trigger the alarms, which are immediately sent to the designated physician who can check the portal in real-time from any device with an Internet connection, contact the patient, if need be, and initiate the anti-infective therapy almost instantly after the first symptoms occur.Results: Fifty hemato-oncological patients were recruited between March 1, 2018 and August 1, 2020. Two hundred ninety-seven alarms of body temperature were registered and checked by the physician and patients were contacted in 18.5% of the cases (55/297). Among these 55 events, 13 required medical assistance, which makes it approximately one-quarter of all conducted telephone interventions (23.4%) and neither septic shock nor death due to treatment-related toxicity occurred.Conclusion: Telemedicine seems like a useful tool to improve the safety of high risk hemato-oncological patients when treatment-related infectious complications are concerned.Keywords: telemedicine, patient monitoring, hematologic neoplasms, chemotherapy-induced febrile neutropenia, cancer, vulnerable populations
