Wearable cuff device enables monitoring of haematologic cancer patients on aggressive treatment

Using a wearable medical cuff device can facilitate the continuous monitoring of vital signs, physical activity, and complications in patients on intensive treatment regimens for aggressive haematologic malignancies, according to a recent study.

“The results of this trial indicate that patients on intensive treatment protocols adhere to a self-managed wearable despite high symptom burden. The sensors of the device show variable recording quality, which places high demands on the software-supported data interpretation,” the researchers said.

“Our findings encourage future research using wearables for remote patient monitoring during intensive oncologic treatment protocols,” they added. “Improved monitoring may lead to earlier identification and treatment of complications and thereby reduce treatment-associated morbidity and mortality.”

Seventy-nine patients participated in the present single-arm observational trial, 54 of whom received inpatient care while 25 were seen on an outpatient basis. In the inpatient cohort, the 100-day mortality was 1.9 percent and the admission rate to intensive care was 5.6 percent. Neither endpoint was reported in outpatients, though they had a 100-day unplanned hospitalization rate of 36.0 percent. [JCO Clin Cancer Inform 2022;doi:10.1200/CCI.21.00126]

Device use was reasonably high. Wearable recordings accounted for 78.0 percent and 84.6 percent of the total potential recording time in the inpatient and outpatient cohorts, respectively. Only 19 and 3 patients in the inpatient and outpatient groups dropped out, respectively. Common reasons for leaving the trial included discomfort with the device, stress due to parallel medical procedures, emotional stress, and technical issues.

The cuff device was designed to collect multiple patient parameters, such as heart rate, oxygen saturation, temperature, respiratory rate, and physical activity. To check the plausibility of device measurements, the researchers plotted heart rate and physical activity over the duration of the trial.

In both groups, heart rate showed an early and pronounced decrease 3 days after commencing intensive treatment, followed by a steady increase to levels higher than 80 bpm. In the inpatient cohort, heart rate continued to rise until day 35, while outpatients saw a subsequent decline in heart rate to below baseline levels.

Physical activity, on the other hand, was divergent between study groups. Inpatients had lower physical activity levels than outpatients, a trend that remained consistent throughout the study period.

“It is worth mentioning that the wearable used in this trial is not a lifestyle device,” the researchers said. “Instead, it was selected on the basis of the multiple sensors and the high amount of measured data points; that is, high signal resolution.”

“Implementation of RPM in clinical oncology offers an option of continuous surveillance of patients,” they added. “This may improve detection of complications throughout the clinical course of the disease and could thereby optimize the timing of interventions. Ideally, the recorded data would be automatically analysed to provide immediate actionable information.” [J Oncol Pract 2017;13:82-89, JCO Clin Cancer Inform 2018;2:1-9]