JMIR Publications

ABSTRACT

Background:

As the number of Remote Patient Monitoring (RPM) interventions expands rapidly, there is a growing need to evaluate and compare them. The Sextuple Aim was proposed to capture the value of RPM interventions from a multistakeholder perspective.

Objective:

This study aimed to identify the most important value aspects for evaluating RPM interventions from the Sextuple Aim-domains.

Methods:

Three Delphi rounds involving rating and ranking of value aspects were conducted to reach a consensus on their importance. We tasked six stakeholder groups (patients, informal caregivers, researchers, healthcare providers, managers, and insurers) to rate value aspects on a five-point Likert-scale for importance. Rankings were used to determine the relative importance of the value aspects within and across domains. A multicriteria consensus rule was used to select value aspects for the preliminary core outcome set (COS). The COS was finalized during a multistakeholder expert meeting, and relevant value aspects for patients were confirmed through semi-structured interviews with patients with limited health literacy.

Results:

Of the 171 respondents, 137 (80%) completed all three rounds. After (re-)rating, 32 out of in total 47 value aspects (68%) met the rating-consensus criterion. Following the ranking exercises, 26 value aspects (55%) met the multicriteria consensus rule. During the expert meeting, conceptual overlap was identified among value aspects within and across domains, and one value aspect was added. Semi-structured interviews confirmed the relevance of the patient-related value aspects that met the aforementioned criteria. The final COS included 18 value aspects across all Sextuple Aim-domains.

Conclusions:

An RPM Sextuple Aim-COS comprising 18 value aspects was developed using the Delphi method, an expert meeting, and semi-structured interviews. This core outcome set can support the validation and refinement of tools used to evaluate RPM. Future research should focus on translating the core outcome set into measurable outcomes and assessing the feasibility and acceptability of its use in practice.