Telemonitoring of Patients With Chronic Traumatic Brain Injury: A Pilot Study
Telehealth systems have shown success in the remote management of several neurological disorders, but there is a paucity of evidence in disorders of consciousness (DOC). In this study, we explore the effectiveness of a new telemonitoring system, for monitoring Vegetative State (VS) and Minimally Con...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-04-01
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| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.598777/full |
| _version_ | 1818621004358877184 |
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| author | Maria Girolama Raso Francesco Arcuri Stefano Liperoti Luca Mercurio Aldo Mauro Francesco Cusato Lidia Romania Sebastiano Serra Loris Pignolo Paolo Tonin Antonio Cerasa Antonio Cerasa |
| author_facet | Maria Girolama Raso Francesco Arcuri Stefano Liperoti Luca Mercurio Aldo Mauro Francesco Cusato Lidia Romania Sebastiano Serra Loris Pignolo Paolo Tonin Antonio Cerasa Antonio Cerasa |
| author_sort | Maria Girolama Raso |
| collection | DOAJ |
| description | Telehealth systems have shown success in the remote management of several neurological disorders, but there is a paucity of evidence in disorders of consciousness (DOC). In this study, we explore the effectiveness of a new telemonitoring system, for monitoring Vegetative State (VS) and Minimally Conscious State (MCS) patients. This was a prospective, mono-center randomized controlled study. We included only traumatic brain injury (TBI) patients who required long-term motor/cognitive assistance having a stable clinical condition. We examined their clinical evolution over ~4 years of the follow-up period. Twenty-two TBI patients were enrolled and equally divided into two groups: one telemonitored at home with our service and the second admitted to a standard long-stay hospitalization (LSH) program. Patients enrolled in the telehealth service (age: 49.9 ± 20.4; 45% female; diagnosis: 36% VS/64% MCS) were demographically and clinically-matched with those admitted to the LSH program (age: 55.1 ± 15; 18% female; diagnosis: 54% VS/46% MCS). Thirty-six percent of patients in the LSH program died before completing follow up evaluation with respect to 18% of death in the group of TBI patients telemonitored at home. At follow-up, patients in LSH and telemonitoring groups showed similar clinical progression, as measured by CRS-r, NCS, WHIM, and LCF scales, as well as by the number of medical complications (i.e., bedsores, infections). Finally, we estimated the total daily cost per patient. Severe TBI patients enrolled in the conventional LSH program cost 262€ every single day, whereas the cost per patient in the telehealth service resulted to be less expensive (93€). Here, we highlight that our telehealth monitoring service is as efficacious as in-person usual care to manage a severe neurological disorder such as TBI in a cost-effective way. |
| first_indexed | 2024-12-16T18:02:23Z |
| format | Article |
| id | doaj.art-5dde9625e14644d1a8033f17bc91bfa4 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-16T18:02:23Z |
| publishDate | 2021-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-5dde9625e14644d1a8033f17bc91bfa42022-12-21T22:22:01ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-04-011210.3389/fneur.2021.598777598777Telemonitoring of Patients With Chronic Traumatic Brain Injury: A Pilot StudyMaria Girolama Raso0Francesco Arcuri1Stefano Liperoti2Luca Mercurio3Aldo Mauro4Francesco Cusato5Lidia Romania6Sebastiano Serra7Loris Pignolo8Paolo Tonin9Antonio Cerasa10Antonio Cerasa11Sant'Anna Institute, Crotone, ItalySant'Anna Institute, Crotone, ItalySant'Anna Institute, Crotone, ItalySant'Anna Institute, Crotone, ItalySant'Anna Institute, Crotone, ItalySant'Anna Institute, Crotone, ItalySant'Anna Institute, Crotone, ItalySant'Anna Institute, Crotone, ItalySant'Anna Institute, Crotone, ItalySant'Anna Institute, Crotone, ItalySant'Anna Institute, Crotone, ItalyInstitute for Biomedical Research and Innovation, National Research Council, Palermo, ItalyTelehealth systems have shown success in the remote management of several neurological disorders, but there is a paucity of evidence in disorders of consciousness (DOC). In this study, we explore the effectiveness of a new telemonitoring system, for monitoring Vegetative State (VS) and Minimally Conscious State (MCS) patients. This was a prospective, mono-center randomized controlled study. We included only traumatic brain injury (TBI) patients who required long-term motor/cognitive assistance having a stable clinical condition. We examined their clinical evolution over ~4 years of the follow-up period. Twenty-two TBI patients were enrolled and equally divided into two groups: one telemonitored at home with our service and the second admitted to a standard long-stay hospitalization (LSH) program. Patients enrolled in the telehealth service (age: 49.9 ± 20.4; 45% female; diagnosis: 36% VS/64% MCS) were demographically and clinically-matched with those admitted to the LSH program (age: 55.1 ± 15; 18% female; diagnosis: 54% VS/46% MCS). Thirty-six percent of patients in the LSH program died before completing follow up evaluation with respect to 18% of death in the group of TBI patients telemonitored at home. At follow-up, patients in LSH and telemonitoring groups showed similar clinical progression, as measured by CRS-r, NCS, WHIM, and LCF scales, as well as by the number of medical complications (i.e., bedsores, infections). Finally, we estimated the total daily cost per patient. Severe TBI patients enrolled in the conventional LSH program cost 262€ every single day, whereas the cost per patient in the telehealth service resulted to be less expensive (93€). Here, we highlight that our telehealth monitoring service is as efficacious as in-person usual care to manage a severe neurological disorder such as TBI in a cost-effective way.https://www.frontiersin.org/articles/10.3389/fneur.2021.598777/fulltelerehabilitationtraumatic brain injurymedical complicationshealthcare costscoma recovery scale revised |
| spellingShingle | Maria Girolama Raso Francesco Arcuri Stefano Liperoti Luca Mercurio Aldo Mauro Francesco Cusato Lidia Romania Sebastiano Serra Loris Pignolo Paolo Tonin Antonio Cerasa Antonio Cerasa Telemonitoring of Patients With Chronic Traumatic Brain Injury: A Pilot Study Frontiers in Neurology telerehabilitation traumatic brain injury medical complications healthcare costs coma recovery scale revised |
| title | Telemonitoring of Patients With Chronic Traumatic Brain Injury: A Pilot Study |
| title_full | Telemonitoring of Patients With Chronic Traumatic Brain Injury: A Pilot Study |
| title_fullStr | Telemonitoring of Patients With Chronic Traumatic Brain Injury: A Pilot Study |
| title_full_unstemmed | Telemonitoring of Patients With Chronic Traumatic Brain Injury: A Pilot Study |
| title_short | Telemonitoring of Patients With Chronic Traumatic Brain Injury: A Pilot Study |
| title_sort | telemonitoring of patients with chronic traumatic brain injury a pilot study |
| topic | telerehabilitation traumatic brain injury medical complications healthcare costs coma recovery scale revised |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2021.598777/full |
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