Home telemonitoring of severe chronic respiratory insufficient and asthmatic patients
Telemonitorização domiciliária de insuficientes respiratórios crónicos graves e de doentes asmáticos
1. Mestre em Patologia do Aparelho Respiratório pela Faculdade de Ciências Médicas da Universidade Nova de Lisboa. Assistente Hospitalar Graduada de Pneumologia. Unidade de Reabilitação Respiratória. Hospital de Pulido Valente, Lisboa / MA, Respiratory Apparatus Pathology, Lisbon University School of Medical Sciences. Consultant, Specialist, Pulmonology. Respiratory Rehabilitation Unit, Hospital Pulido Valente, Lisbon
2. Assistente Hospitalar Graduada de Pneumologia. Hospital do Espírito Santo. Évora / Consultant, Specialist, Pulmonology. Hospital do Espírito Santo. Évora
3. Enfermeira Graduada. Unidade de Reabilitação Respiratória. Hospital de Pulido Valente, Lisboa / Consultant Nurse, Respiratory Rehabilitation Unit, Hospital Pulido Valente, Lisbon
4. Professora Catedrática da Faculdade de Ciências Médicas da Universidade Nova de Lisboa. Coordenadora do Centro de Estudos de Doenças Crónicas da Fundação para a Ciência e Tecnologia. Chefe de Serviço de Pneumologia. Hospital de Pulido Valente, Lisboa / Cathedratic Professor, Lisbon Nova University School of Medical Sciences. Coordinator, Centre for the Study of Chronic Diseases, Science and Technology Foundation. Head, Pulmonology Service, Hospital Pulido Valente, Lisbon
5. Departamento de Pneumologia do Hospital de Pulido Valente, Alameda das Linhas de Torres 117 – Lisboa
6. Serviço de Especialidades Médicas do Hospital do Espírito Santo, Largo Senhor da Pobreza – 7000-811 Évora
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Assistente Hospitalar Graduada de Pneumologia. Unidade de Reabilitação Respiratória. Hospital de Pulido Valente, Lisboa / <span class="elsevierStyleItalic">MA, Respiratory Apparatus Pathology, Lisbon University School of Medical Sciences. Consultant, Specialist, Pulmonology. Respiratory Rehabilitation Unit, Hospital Pulido Valente, Lisbon</span>" "etiqueta" => "<span class="elsevierStyleSup">1.</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Assistente Hospitalar Graduada de Pneumologia. Hospital do Espírito Santo. Évora / <span class="elsevierStyleItalic">Consultant, Specialist, Pulmonology. Hospital do Espírito Santo. Évora</span>" "etiqueta" => "<span class="elsevierStyleSup">2.</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Enfermeira Graduada. Unidade de Reabilitação Respiratória. Hospital de Pulido Valente, Lisboa / <span class="elsevierStyleItalic">Consultant Nurse, Respiratory Rehabilitation Unit, Hospital Pulido Valente, Lisbon</span>" "etiqueta" => "<span class="elsevierStyleSup">3.</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Professora Catedrática da Faculdade de Ciências Médicas da Universidade Nova de Lisboa. Coordenadora do Centro de Estudos de Doenças Crónicas da Fundação para a Ciência e Tecnologia. Chefe de Serviço de Pneumologia. Hospital de Pulido Valente, Lisboa / <span class="elsevierStyleItalic">Cathedratic Professor, Lisbon Nova University School of Medical Sciences. Coordinator, Centre for the Study of Chronic Diseases, Science and Technology Foundation. Head, Pulmonology Service, Hospital Pulido Valente, Lisbon</span>" "etiqueta" => "<span class="elsevierStyleSup">4.</span>" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Departamento de Pneumologia do Hospital de Pulido Valente, Alameda das Linhas de Torres 117 – Lisboa" "etiqueta" => "<span class="elsevierStyleSup">5.</span>" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Serviço de Especialidades Médicas do Hospital do Espírito Santo, Largo Senhor da Pobreza – 7000-811 Évora" "etiqueta" => "<span class="elsevierStyleSup">6.</span>" "identificador" => "aff0030" ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Telemonitorização domiciliária de insuficientes respiratórios crónicos graves e de doentes asmáticos" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2008-12-04" "fechaAceptado" => "2009-01-12" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key-words" "identificador" => "xpalclavsec160079" "palabras" => array:4 [ 0 => "Asthma" 1 => "severe chronic respiratory failure" 2 => "ambulatory care" 3 => "telemedicine" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chaves" "identificador" => "xpalclavsec160078" "palabras" => array:4 [ 0 => "Asma" 1 => "DPOC" 2 => "cuidados ambulatorios" 3 => "telemedicina" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">For 9 months we evaluated a portable device to transfer patient-clinician data by Internet: oximetry, ECG, clinical questionnaires and messages from the doctor. Fifty-one patients with severe chronic respiratory insufficiency (CRI) were followed at the hospital Pulido Valente and Espirito Santo and 21 asthmatics (A) were followed at the latter hospital. The use and acceptance of this device was evaluated through questionnaires soliciting patients’ and health professionals’ opinions. Patients with CRI followed in Lisbon were also asked about hospital admissions and quality of life compared with a nine month period before the monitoring programme.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">CRI patients found learning to use the system more difficult; the majority (80%) reported problems with the equipment, qualified as rare/occasional in 62% of the cases. For 31 CRI patients followed in Lisbon, the use of the system was classified as correct in 12 patients, incorrect in 7 and reasonable in 12 patients. The first group had a reducded number and duration of hospital admissions and also improved quality of life. With this remote monitoring system 80% of CRI patients reported they were more/much more supported and 33 patients (75%) would use this system in the future. 81% of asthmatic patients would also like to maintain this type of monitoring. The service was considered useful by the researchers. We concluded that home telemonitoring was a positive contribution to the management of chronic patients and raised awareness of it should be considered in the future.</p>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Durante nove meses avaliámos umdispositivo portátil para transferência de dados pelaInternet entre doentes e profissionais de saúde: oximetria,ECG, respostas a questionários e mensagens. Foramincluídos 51 insuficientes respiratórioscrónicos (IRC) graves acompanhados no Hospital de PulidoValente (Lisboa) e no Hospital do Espírito Santo(Évora) e 21 asmáticos deste último hospital. Autilização e a aceitação destedispositivo foram avaliadas através de questionáriosque registaram a opinião dos doentes e dos profissionais desaúde. Nos IRC de Lisboa avaliou-se a repercussão deste progra-ma sobre internamentos hospitalares e qualidade de vida dos doentes.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Aprender a utilizar o sistema foi maisdifícil para os doentes IRC; a maioria (80%) teve problemas com o equipamento, qualificados como raros/ocasionais em 62% dos casos.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Para 31 doentes IRC seguidos nohospital de Lisboa, a utilização do sistema foiclassificada como correcta em12 doentes, incorrecta em 7 erazoável em12 doentes. Os primeiros tiveramredução do número e duração dosinternamentos em relação a igual períodoanterior ao programa de telemonitorização e melhoria daqualidade de vida, em particular no domínio da actividade. Comeste sistema de telemonitorização 80% dos doentes IRCsentiramse mais/muito mais apoiados e 33 (75%) utilizariam estesistema no futuro, se ele estivesse disponível. No grupo dedoentes asmáticos, 81% gostariam de manter este tipo devigilância. O serviço foi considerado útil pelos investigadores.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Concluímos que atelemonitorização domiciliária constitui umacontribuição positiva para a gestáo dos doentescrónicos e a sua divulgação deverá ser considerada no futuro.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography/Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "WHO / NIHLD. 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