Wearable Remote Monitoring Device May Help Patients With Blood Cancers Identify When to Seek Follow-Up Care

The use of a remote wearable device that monitors vital signs and physical activity was shown to be beneficial for patients with hematologic malignancies undergoing intensive treatment regimens, as it helped indicate when they needed to seek assistance from their health care provider, according to new research.

The study results, which were published in JCO Clinical Cancer Informatics, also showed that patients tolerated wearing the device.

Intensive treatment protocols for hematologic malignancies such as stem-cell transplantation, monoclonal antibody and CAR-T cell therapy may put patients at risk for things like infections, systemic immune reactions and arrhythmias (abnormal heartbeat). Additionally, patients may experience other medication side effects such as symptom exacerbation and cytokine release syndrome (which involves the cytokines overstimulating the immune system so that it attacks healthy organs).

“In fact, nearly every patient on these treatment protocols experiences at least one complication requiring follow-up treatment,” the authors wrote in the study.

While early diagnosis and treatment of these complications may reduce potential illness or death, treatment access is often affected by limited capacity at health care centers, increased costs and nursing staff shortages — which is why remote patient monitoring could be helpful in identifying and addressing complications early on.

To assess whether this was a feasible option for patients, the researchers observed 79 patients (54 in the inpatient setting and 25 outpatient), all of whom received a standard-of-care treatment for their cancer. The patients wore and self-managed a device that measured heart rate, oxygen levels and physical activity.

Most of the inpatient group (94.4%) and 64% of the outpatient group reported gastrointestinal symptoms (diarrhea, nausea and vomiting), pain, difficulty breathing or shivering during at least one visit from a health care provider. The vital signs and activity data were recorded by the devices for 1,304.8 days, accounting for 78% of potential recording time for the inpatient group and 84.6% for the outpatient group.

While the adherence to wearing the device was similar between groups, 35% of the inpatient group and 12% of the outpatient group dropped out of the trial, most commonly due to discomfort (27.2%). However, some dropped out due to having other medical procedures such as continuous blood pressure measurements, which made it stressful (22.7%). Some patients cited emotional stress (18.1%) or technical issues (13.6%) as reasons for dropping out.

“Despite the fact that patients on intensive treatment protocols for hematologic malignancies experience high symptom burden, our trial shows that they are willing and able to carry a wearable (device) for remote patient monitoring for a large proportion of the potential recording time and that most data gathered by a device will be interpretable,” the study authors wrote.

They added that the wearable band used in the trial was not a lifestyle device, meaning it did not have a display or fitness tracker. It was worn at the upper arm, and the study authors wrote that it was user-friendly, takes roughly 90 minutes to charge and has low interference with movements and therapy.

“To improve adherence, wearables should be even smaller and more convenient in terms of charging procedures,” the authors wrote.

To conclude, the researchers noted that this trial provides evidence that the wearable approach of consistent monitoring is possible and generally well-tolerated.

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