Telehealth at scale can improve chronic disease management in the community during a pandemic: An experience at the time of COVID-19.

<h4>Background</h4>During the COVID-19 pandemic, telehealth became a vital resource to contain the virus's spread and ensure continuity of care of patients with a chronic condition, notably arterial hypertension and heart disease. This paper reports the experience based on a telehea...

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Autores principales:	Stefano Omboni, Tommaso Ballatore, Franco Rizzi, Fernanda Tomassini, Edoardo Panzeri, Luca Campolo
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8d4fce2d70f24cd98f9ea1998f3a86df
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spelling	oai:doaj.org-article:8d4fce2d70f24cd98f9ea1998f3a86df2021-11-25T06:18:59ZTelehealth at scale can improve chronic disease management in the community during a pandemic: An experience at the time of COVID-19.1932-620310.1371/journal.pone.0258015https://doaj.org/article/8d4fce2d70f24cd98f9ea1998f3a86df2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258015https://doaj.org/toc/1932-6203<h4>Background</h4>During the COVID-19 pandemic, telehealth became a vital resource to contain the virus's spread and ensure continuity of care of patients with a chronic condition, notably arterial hypertension and heart disease. This paper reports the experience based on a telehealth platform used at scale to manage chronic disease patients in the Italian community.<h4>Methods and findings</h4>Patients' health status was remotely monitored through ambulatory blood pressure monitoring (ABPM), resting or ambulatory electrocardiogram (ECG), spirometry, sleep oximetry, and cardiorespiratory polysomnography performed in community pharmacies or general practitioners' offices. Patients also monitored their blood pressure (BP), heart rate (HR), blood oxygen saturation (SpO2), body temperature, body weight, waist circumference, blood glucose, and lipids at home through a dedicated smartphone app. All data conveyed to the web-based telehealth platform were used to manage critical patients by doctors promptly. Data were analyzed and compared across three consecutive periods of 2 months each: i) before the national lockdown, ii) during the lockdown (from March 9 to May 17, 2020), and iii) after the end of the containment measures. Overall, 13,613 patients visited community pharmacies or doctors' offices. The number of overall tests dropped during and rose after the lockdown. The overall proportion of abnormal tests was larger during the outbreak. A significant increase in the prevalence of abnormal ECGs due to myocardial ischemia, contrasted by a significantly improved BP control, was observed. The number of home users and readings exchanged increased during the pandemic. In 226 patients, a significant increase in the proportion of SpO2 readings and a significant reduction in the entries for all other parameters, except BP, was observed. The proportion of abnormal SpO2 and BP values was significantly lower during the lockdown. Following the lockdown, the proportion of abnormal body weight or waist circumference values increased.<h4>Conclusions</h4>Our study results support the usefulness of a telehealth solution to detect deterioration of the health status during the COVID-19 pandemic.<h4>Trial registration</h4>The study is registered with ClinicalTrials.gov at number NCT03781401.Stefano OmboniTommaso BallatoreFranco RizziFernanda TomassiniEdoardo PanzeriLuca CampoloPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0258015 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Stefano Omboni Tommaso Ballatore Franco Rizzi Fernanda Tomassini Edoardo Panzeri Luca Campolo Telehealth at scale can improve chronic disease management in the community during a pandemic: An experience at the time of COVID-19.
description	<h4>Background</h4>During the COVID-19 pandemic, telehealth became a vital resource to contain the virus's spread and ensure continuity of care of patients with a chronic condition, notably arterial hypertension and heart disease. This paper reports the experience based on a telehealth platform used at scale to manage chronic disease patients in the Italian community.<h4>Methods and findings</h4>Patients' health status was remotely monitored through ambulatory blood pressure monitoring (ABPM), resting or ambulatory electrocardiogram (ECG), spirometry, sleep oximetry, and cardiorespiratory polysomnography performed in community pharmacies or general practitioners' offices. Patients also monitored their blood pressure (BP), heart rate (HR), blood oxygen saturation (SpO2), body temperature, body weight, waist circumference, blood glucose, and lipids at home through a dedicated smartphone app. All data conveyed to the web-based telehealth platform were used to manage critical patients by doctors promptly. Data were analyzed and compared across three consecutive periods of 2 months each: i) before the national lockdown, ii) during the lockdown (from March 9 to May 17, 2020), and iii) after the end of the containment measures. Overall, 13,613 patients visited community pharmacies or doctors' offices. The number of overall tests dropped during and rose after the lockdown. The overall proportion of abnormal tests was larger during the outbreak. A significant increase in the prevalence of abnormal ECGs due to myocardial ischemia, contrasted by a significantly improved BP control, was observed. The number of home users and readings exchanged increased during the pandemic. In 226 patients, a significant increase in the proportion of SpO2 readings and a significant reduction in the entries for all other parameters, except BP, was observed. The proportion of abnormal SpO2 and BP values was significantly lower during the lockdown. Following the lockdown, the proportion of abnormal body weight or waist circumference values increased.<h4>Conclusions</h4>Our study results support the usefulness of a telehealth solution to detect deterioration of the health status during the COVID-19 pandemic.<h4>Trial registration</h4>The study is registered with ClinicalTrials.gov at number NCT03781401.
format	article
author	Stefano Omboni Tommaso Ballatore Franco Rizzi Fernanda Tomassini Edoardo Panzeri Luca Campolo
author_facet	Stefano Omboni Tommaso Ballatore Franco Rizzi Fernanda Tomassini Edoardo Panzeri Luca Campolo
author_sort	Stefano Omboni
title	Telehealth at scale can improve chronic disease management in the community during a pandemic: An experience at the time of COVID-19.
title_short	Telehealth at scale can improve chronic disease management in the community during a pandemic: An experience at the time of COVID-19.
title_full	Telehealth at scale can improve chronic disease management in the community during a pandemic: An experience at the time of COVID-19.
title_fullStr	Telehealth at scale can improve chronic disease management in the community during a pandemic: An experience at the time of COVID-19.
title_full_unstemmed	Telehealth at scale can improve chronic disease management in the community during a pandemic: An experience at the time of COVID-19.
title_sort	telehealth at scale can improve chronic disease management in the community during a pandemic: an experience at the time of covid-19.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/8d4fce2d70f24cd98f9ea1998f3a86df
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Telehealth at scale can improve chronic disease management in the community during a pandemic: An experience at the time of COVID-19.

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