JMIR Publications

ABSTRACT

Background:

Healthcare systems are increasingly confronted by the challenge posed by the aging population. In particular, hospitalization, both initial and subsequent, is often observed among the polypathological elderly, while it is estimated that over 30% of such hospitalizations could be avoided. In this context, remote patient monitoring (RPM) systems offer a promising solution, enabling early detection and management of patient complexity.

Objective:

This study aims to provide a complementary analysis of the impact of the EPOCA RPM system for polypathological elderly people, on the total number of unplanned hospitalization days and admissions, as well as emergency department (ED) visits. In an earlier study, we evaluated the EPOCA PRM system when the system operator is a geriatrician; in the current one, we evaluate the case when the general practitioner (GP) is the operator.

Methods:

A retrospective, before-and-after cohort design was used for the purposes of this study. Patients who benefited from the EPOCA RPM system for more than one year (between February 2022 and August 2024), aged over 70 and with two or more pathologies were included in the analysis. We compared the total number of unplanned hospital admissions, hospitalization days and ED visits between the previous year (Y-1) and the year (Y) of follow-up by the EPOCA RPM system. Statistical analyses were significant at P-value < .05

Results:

A total of 80 patients were included, with an average age of 87. Our study showed a significant reduction in hospitalization days by 49% between Y-1 and Y. There was also a significant decrease in the number of unplanned hospital admissions (-57%) and ED visits (-62%). These results were seen by a significant decrease from 0.99 to 0.42 per patient in the number of hospitalizations, from 0.99 to 0.37 in emergency room visits and a reduction of 9.7 hospital days per year per patient, P-value< .001. In addition, there was no observed increase in mortality or transfers to intensive care units

Conclusions:

The results of this study support our earlier findings on the potential benefits of EPOCA RPM for managing complex, polypathological elderly patients, this time with the GP as system operator. RPM systems can support GPs and caregivers manage complex geriatric patient care, help reduce healthcare costs and the burden on hospital services, while enabling patients to remain safely at home. Further evidence on the effectiveness of EPOCA RPM system may be obtained in a future large randomized controlled trial