Nuevas estrategias de atención y cuidado en el contexto de una pandemia: Desarrollo de un sistema de monitorización de síntomas telemático en pacientes con enfermedades avanzadas (AvanzaT).

Abstract

Background: Telemedicine initiatives involve patients in their care, promote adherence to treatment, and help focus face-to-face assessments on the most important problems, improving care in general.Objective: Design and evaluation of the feasibility of an app aimed at monitoring clinical status in patients with advanced diseases.Material and methods: Type of study: qualitative (app design)-quantitative (evaluation in patients). Location: Palliative Care Units at the Ntra. Sra. de Candelaria University Hospital Complex (CHUNSC) in Tenerife, and Ferrol University Hospital Complex (CHUF). Intervention: app development by experts in advanced diseases and a health app development team. Evaluation: analysis of the use of the app by patients and professionals, contribution to daily monitoring, and satisfaction with its use.Results: After focus group meetings (n = 6) and presentations (n = 3) in participating units, the app was developed and published on regular servers (Apple Store and Play Store). For its evaluation 60 patients (60 % women) were recruited. Average age was 72 years. Follow-up: 76 % had cancer, 12 % lung disease, and 8 % amyotrophic lateral sclerosis; 70 % with previous follow-up. In 60 % the information was collected from relatives/caregivers. Median follow-up of 52 days (interquartile range, 14-104). In all, 69 % (41) had follow-up > 30 days (10 deceased and 9 without data). The chat was used in 56 % of cases by patients and in 79 % by professionals. Sections: blood pressure used by 77 %, heart rate by 72 %, saturation by 60 %, temperature by 50 %, glycemia by 37 %, functional status and symptom control by 85 %, the Bristol scale by 80 %, and the ROMA Scale by 90 %. Information on medication was obtained for 85 % of cases. Patients and caregivers were very satisfied with its ease of use and usefulness.Conclusions: It is possible to develop a novel form of follow-up in patients with advanced diseases to improve their accessibility to health services and provide valuable information for their follow-up while being well accepted by users.