JMIR Publications

ABSTRACT

Background:

Hematological patients receiving hematopoietic cell transplantation (HCT) or chimeric antigen receptor (CAR) T-cell therapy are at the risk of developing serious clinical complications after discharge.

Objective:

The aim of the TEL-HEMATO study was to improve our telehealth platform for the follow-up of HCT and CAR T-cell therapy patients during the first 3 months from discharge with the addition of wearable devices.

Methods:

Eleven patients who received autologous (n=2) or allogeneic HCT (n=5) or CAR T-cell therapy (n=4) for hematological malignancies were screened from November 2022 to July 2023. The telehealth platform consisted of the daily collection of vital signs, physical symptoms and quality of life assessment up to 3 months after hospital discharge. Each patient received a clinically validated scanwatch and a digital thermometer, and a dedicated smartphone application was used to collect these data. Daily revision of the data was performed through a web-based platform by a hematologist or a nurse specialized in HCT and CAR T-cell therapy.

Results:

Vital signs measured through the scanwatch were successfully collected with medium/high adherence (heart rate recorded in 89% of patients, oxygen saturation and daily steps recorded in 100% of patients, sleeping hours recorded in 78% of patients) while temperature recorded by manual intervention had lower compliance (data recorded in 55% of patients). Fifty-five percent of patients reported clinical symptoms into the app. Quality of life assessment was reported in 89% at study enrollment and decreased to 33% at the end of the third month. Usability was considered acceptable through the System Usability Scale . However, technological issues were still reported from the patients.

Conclusions:

While the addition of wearable devices to a telehealth clinical platform could be potentially synergic for HCT and CAR T-cell therapy patient monitoring, non-complete automation of the platform and the absence of a dedicated telemedicine team still represent major limitations. This is especially true in our real-life setting where older age of patients and a low digital education level is generally observed. Clinical Trial: Not required.