Remote Home Monitoring Acute Pancreatitis

Rijnstate Hospital70 enrolled

Overview

Acute pancreatitis is an inflammation of the pancreas which causes abdominal pain and is the most common gastro-intestinal reason for acute hospitalization in Western countries. Because care for a mild acute pancreatitis is supportive, early discharge of patients with a predicted mild course of acute pancreatitis might be safe with the use of remote home monitoring. This might reduce the demand for hospital beds and allow patients to benefit from recovering in their home environment. Therefore, the aim of this study is to assess the feasibility of a novel care pathway in which patients with a predicted mild course of acute pancreatitis are discharged early with remote home monitoring.

Study Type

INTERVENTIONAL

Allocation

Purpose

OTHER

Masking

NONE

Enrollment

Conditions

Acute Pancreatitis Telemedicine Healthdot Patient Discharge Monitoring

Interventions

Early discharge with remote home monitoring.OTHER

After at least 48 hours of hospital admission, patients are discharged early with the use of remote home monitoring. During home monitoring, heartrate, respiratory rate, posture and movement are monitored every 5 minutes for at least 4 days, using a wearable sensor. Core temperature is monitored using an ear thermometer. Patients are contacted once per day by a nurse from the Virtual Monitoring Centre (VMC) to assess pancreatitis related complaints, intake of fluids and food, pain and the use of analgesics. Patients are asked to provide information to the hospital using a smartphone app.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Have 2 out of 3 revised Atlanta criteria for pancreatitis: * Abdominal pain consistent with acute pancreatitis * Serum lipase ≥ 3x upper limit normal (\> 159 U/l) * Typical pancreatic abnormalities on imaging (ultrasound, CT or MRI) * First episode of acute pancreatitis or a prior pancreatitis more than 3 months ago. * Age ≥18 years, both men and women. * Able and willing to provide written informed consent. * In possession of a working (smart)phone on which patient can be reached for the duration of participation (30 days). Exclusion Criteria: * Chronic pancreatitis according to M-ANNHEIM criteria (20). * Signs of severe pancreatitis at the moment of admission to the GE ward: * Serum CRP \> 150 mg/l * More than one SIRS criteria: * temperature \< 36◦C or \> 38◦C * heart rate \> 90/min * respiratory rate \>20/min * leucocytes \< 4x/109l or \> 12x109/l * MEWS (Modified Early Warning Score) ≥6 or in need of ICU admission * Living alone or in an institution (e.g. psychiatric ward or nursing home) * Known sensitivity to medical adhesives * Known pregnancy * Have one or more of the following comorbidities: * Heart failure (NYHA class III or IV) * COPD (Gold III-IV) * Kidney disease (\>G3b) and/or kidney replacement therapy * Currently undergoing oncological treatment * Use of immunosuppressants * Dysregulated or poorly controlled insulin dependent diabetes * Morbid obesity (BMI\>35 kg/m2) * Implantable Cardioverter Defibrillator (ICD) or Pacemaker