Evaluation of a Telemedicine System for Patients Carried for Bariatric Surgery

NCT ID: NCT03834181

Last Updated: 2021-02-10

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 24 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2019-04-15
• Study Completion Date: 2020-08-31

Brief Summary

This study is intended to study the feasibility of a telemedicine system to monitor and control certain vital parameters before and after surgery for obesity. During the preoperative preparation phase, weight, exercise, blood pressure and heart rate are recorded and transmitted to the patient's surgeon. In the immediate post operative period, the heart rate is a sensitive and reliable indicator of the occurrence of a complication. A telemetry system will allow rapid home return, continuous monitoring and early warning in the event of a problem. Prolonged follow-up identical to that started preoperatively should allow improvement and better control of weight loss by monitoring especially physical exercise.

Detailed Description

The evolution of the health system requires a rationalization of the supply of care and the care of patients. It has allowed the evolution and generalization of ambulatory surgery for certain pathologies. For other pathologies, a hospital stay is still desirable with a tendency to decrease the length of stay. Thanks to the telemedicine platforms, specialized medical monitoring can be extended pre- and post-operatively to ensure good patient preparation and quality secure follow-up.

Early return to home is an essential parameter in optimizing the distribution of hospital resources. Several studies have shown improved clinical outcomes, fewer complications, more beds available, and lower hospital costs. The development of outpatient surgery has enabled the establishment of systems allowing a return home in secure conditions. Early return home is also a wish of the patient. He becomes an actor of his own health. Obesity surgery is an exemplary specialty for the care of patients. The ideal course of care is perfectly codified both preoperatively and postoperatively. Nevertheless, this ideal care path is not always respected especially in structures too small to offer a real integrated multidisciplinary follow-up. Pre- and postoperative management solutions on the Internet exist but require a voluntary and active adherence of the patient. They allow a stronger involvement of the patient in his approach, they are nascent and integrate no connected solution for automated monitoring of the patient. Telemedicine can now allow continuous monitoring without the need for face-to-face interaction. The automatic collection of the physical activity and the heart rate makes it possible to guarantee the involvement of the patient in his preparation. After the intervention, the monitoring of the occurrence of complications can be delegated to connected objects with alert transmission according to parameters defined in advance. In particular, the heart rate is a sensitive indicator and will be followed by two sensors (activity bracelet and pulse oximeter). These complications occur mainly in the 15 days following the intervention, they are rare in immediate postoperative. The hospital stay is no longer necessary for a simple surveillance. In case of receipt of an alert, the surgeon contacts the patient to check his state of health. An adapted action is then engaged.

The late postoperative follow-up throughout this document corresponds to the phase following the immediate postoperative phase. This late postoperative follow-up can be improved with the support of telemonitoring (activity, change in weight.) The addition of connected devices allows a stronger and faster interaction between the patient and his doctors, providing close monitoring and appropriate support.

The study focuses on assessing the reliability of a remote monitoring system. The implementation of this remote monitoring system is subordinated to the reliability of the data transmissions between the connected objects and the remote site which receives the data, interprets them and generates the alerts.

The motivation of the patient is appreciated by the acceptance of connected objects.

During this study, the remote monitoring system is offered in addition to the usual care. The usual care does not change and is not impaired. This study concerns only one group of patients, there is no control group since the investigators seek to validate the reliability of remote surveillance.

Conditions

Bariatric Surgery Candidate

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: NONE

Study Groups

Monitoring evaluation

Monitoring evaluation by connected devices: Wristband activity tracker "Garmin Vivosmart® 3", "Fora® Scale 550", "Terraillon® Tensioscreen", Pulse oximeter "Nonin® 3230", thermometer "Fora® IR20b"

Group Type: EXPERIMENTAL

Monitoring evaluation by connected devices: Wristband activity tracker "Garmin Vivosmart® 3", "Fora® Scale 550", "Terraillon® Tensioscreen", Pulse oximeter "Nonin® 3230", thermometer "Fora® IR20b"

Intervention Type: DEVICE

All patients will be monitored before and after the bariatric surgery:

• During the preoperative preparation phase: weight, exercise, blood pressure and heart rate
• In the immediate post operative period: continuous monitoring of the heart rate with a telemetry system
• Prolonged follow-up: weight, exercise, blood pressure and heart rate

Interventions

Monitoring evaluation by connected devices: Wristband activity tracker "Garmin Vivosmart® 3", "Fora® Scale 550", "Terraillon® Tensioscreen", Pulse oximeter "Nonin® 3230", thermometer "Fora® IR20b"

All patients will be monitored before and after the bariatric surgery:

• During the preoperative preparation phase: weight, exercise, blood pressure and heart rate
• In the immediate post operative period: continuous monitoring of the heart rate with a telemetry system
• Prolonged follow-up: weight, exercise, blood pressure and heart rate

Intervention Type: DEVICE

Eligibility Criteria

Inclusion Criteria

1. Patient (s) applying for bariatric surgery

2. Patient aged 18 to 65

3. Compliance with the High Authority of Health (HAS) criteria:

• BMI> 40 without comorbidities
• BMI> 35 with cardiovascular, metabolic, respiratory or rheumatic comorbidity,
• Psychological follow-up well followed for 4 to 6 months

4. Patient with an ASA (American Society of Anesthesiologists) score less than or equal to 2

5. Patient able to receive and understand information about the study

6. Patient able to manipulate connected objects

7. Patient (e) affiliated to the French social security system

8. Patient who does not live in the white area of wireless telephone coverage.

Exclusion Criteria

1. Patient unable to give informed consent

2. Patient unable to use the connected tools (Internet)

3. Patient whose general condition is not favorable to participation in the study

4. Patient presenting, in the opinion of the investigator, a condition that may prevent participation in the procedures provided for in the study

5. Patient in exclusion period (determined by previous or current study)

6. Patient under the protection of justice

7. Patient under guardianship or trusteeship

8. Patient with epilepsy

9. Patient who is sensitive to light flashes

10. Patient with deformity of the ear

11. Patient with bleeding ear

1. Patient whose home is in a white GSM (Global System for Mobile Communications) zone or white zone in reception and 3G (third generation) transmission

2. Patient (e) not knowing how to use connected objects.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

IHU Strasbourg

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Michel Vix, MD

Role: PRINCIPAL_INVESTIGATOR

Service Chirurgie Digestive et Endocrinienne, Nouvel Hôpital Civil de Strasbourg

Locations

Service de Chirurgie Digestive et Endocrinienne, NHC

Strasbourg, , France

Countries

France

References

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Other Identifiers

18-003

Identifier Type: -

Identifier Source: org_study_id