Chronic respiratory diseases: what can remote monitoring offer?
In 2019, around 4.3% of the EU population aged 15 and over reported having a chronic lower respiratory disease (other than asthma) diagnosed by a doctor [1].
In France, over 1.6 million people [2] are treated at home for chronic respiratory diseases such as sleep apnea and respiratory failure. For these patients, telemonitoring represents a pertinent response to the need for regular monitoring of the therapeutic efficacy of the treatments in place.
In particular, the transmission of information helps to target, anticipate and personalize interventions. Digital technologies also help to attenuate geographical inequalities in access to appropriate monitoring and care [3].
We distinguish:
• Remote follow up : remote monitoring by the HomeCare Provider (HCP) of data relating to the correct operation of treatment devices [4].
• Telemonitoring : a telemedicine procedure involving a doctor, enabling the efficacy and tolerance of treatment to be monitored and adjusted if necessary[5]. In France, telemonitoring for respiratory failure patients has been eligible for reimbursement since July 1st 2023.
Numerous studies published in the scientific literature attest to the benefits of remote monitoring:
Fewer rehospitalizations
COPD patients on non-invasive ventilation (NIV) have a 34.3% risk of readmission with telemonitoring versus 56% with conventional monitoring [6].
Treatment quality
87% of patients with respiratory insufficiency on NIV meet the 3 satisfactory criteria for telemonitoring (compliance > 4h, AHI < 10/h, leakage < 24L/min) at 6 months and maintain this result at 12 months. [7]
Improved compliance
70% of amyotrophic lateral sclerosis (ALS) patients with home initiation of NIV have a compliance rate of over 4 hours a day after 30 days. [8]
Shorter response time
For patients treated with continuous positive airway pressure (CPAP) for sleep apnea, remote monitoring reduced the time to first technical intervention (29 ± 25 days instead of 47 ± 30) and improved compliance. [9]
Vestalis One
The app dedicated to patients treated at home for sleep-disordered breathing
The Vestalis One app for smartphone and tablet allows you to actively participate in your care:
• Monitor your sleep quality and treatment data
• Benefit from personalized advice and recommendations – Transmit useful information to your healthcare professionals
Downloadable (for patients cared for by professionals using Vestalis) on iPhone or Android:
REFERENCES
[1] https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Respiratory_diseases_statistics#Self-reporting_of_respiratory_diseases
[2] https://www.fedepsad.fr/communiques/FEDEPSAD_1677506290_Notedepresse%20PPC%20PSAD.pdf
[3] https://www.inserm.fr/dossier/apnee-sommeil/
[4] https://www.allianceapnees.org/le-telesuivi-en-7-questions/
[5] https://www.allianceapnees.org/le-telesuivi-en-7-questions/
[6] Weipeng Jiang, Xiaoyan Jin, Chunling Du, et al. (2024). Internet of things-based management versus standard management of home noninvasive ventilation in COPD patients with hypercapnic chronic respiratory failure: a multicentre randomized controlled non-inferiority trial. eClinicalMedicine 2024;70: 102518 Published Online 10 March 2024 https://doi.org/10. 1016/j.eclinm.2024. 102518
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00097-X/fulltext
[7] Pontier-Marchandise S, Texereau J, Prigent A, et al. (2022). Quality of ventilation in patients on home NIV included in a telemonitoring programme – TELVENT study. Eur Respir J 2022; 60: Suppl. 66, 974. doi: 10.1183/13993003.congress-2022.974
https://erj.ersjournals.com/content/60/suppl_66/974
[8] Réginault T, Bouteleux B, Wibart P, et al. (2023). At-home noninvasive ventilation initiation with telemonitoring in amyotrophic lateral sclerosis patients: a retrospective study
ERJ Open Research 2023 9: 00438-2022; DOI: 10.1183/23120541.00438-2022
[9] Hoet F, W. Libert W, Sanida C, et al. (2017). Telemonitoring in continuous positive airway pressure-treated patients improves delay to first intervention and early compliance: a randomized trial. Sleep Medicine, Volume 39, November 2017, Pages 77-83.
https://www.sciencedirect.com/science/article/abs/pii/S1389945717303611?via%3Dihub