Telemonitorização domiciliária de insuficientes respiratórios crónicos graves e de doentes asmáticos

 

Manuela Zamith 1

Teresa Cardoso 2

Isabel Matias 3

Maria João Marques Gomes 4

 

 

Resumo

Durante nove meses avaliámos um dispositivo portátil para transferência de dados pela Internet entre doentes e profissionais de saúde: oximetria, ECG, respostas a questionários e mensagens. Foram incluídos 51 insuficientes respiratórios crónicos (IRC) graves acompanhados no Hospital de Pulido Valente (Lisboa) e no Hospital do Espírito Santo (Évora) e 21 asmáticos deste último hospital. A utilização e a aceitação deste dispositivo foram avaliadas através de questionários que registaram a opinião dos doentes e dos profissionais de saúde. Nos IRC de Lisboa avaliou -se a repercussão deste programa sobre internamentos hospitalares e qualidade de vida dos doentes.

Aprender a utilizar o sistema foi mais difícil para os doentes IRC; a maioria (80%) teve problemas com o equipamento, qualificados como raros/ocasionais em 62% dos casos.

Para 31 doentes IRC seguidos no hospital de Lisboa, a utilização do sistema foi classificada como correcta em12 doentes, incorrecta em 7 e razoável em12 doentes. Os primeiros tiveram redução do número e duração dos internamentos em relação a igual período anterior ao programa de telemonitorização e melhoria da qualidade de vida, em particular no domínio da actividade. Com este sistema de telemonitorização 80% dos doentes IRC sentiram -se mais/muito mais apoiados e 33 (75%) utilizariam este sistema no futuro, se ele estivesse disponível. No grupo de doentes asmáticos, 81% gostariam de manter este tipo de vigilância. O serviço foi considerado útil pelos investigadores.

Concluímos que a telemonitorização domiciliária constitui uma contribuição positiva para a gestão dos doentes crónicos e a sua divulgação deverá ser considerada no futuro.

Palavras -chaves: Asma, DPOC, cuidados ambulatórios,telemedicina.

 

 

Home telemonitoring of severe chronic respiratory insufficient and asthmatic patients

Abstract

For 9 months we evaluated a portable device to transfer patient-clinician data by Internet: oximetry, ECG, clinical questionnaires and messages from the doctor.

Fifty-one patients with severe chronic respiratory insufficiency (CRI) were followed at the hospital Pulido Valente and Espirito Santo and 21 asthmatics (A) were followed at the latter hospital. The use and acceptance of this device was evaluated through questionnaires soliciting patients’ and health professionals opinions. Patients with CRI followed in Lisbon were also asked about hospital admissions and quality of life compared with a nine month period before the monitoring programme.

CRI patients found learning to use the system more difficult; the majority (80%) reported problems with the equipment, qualified as rare/occasional in 62% of the cases. For 31 CRI patients followed in Lisbon, the use of the system was classified as correct in 12 patients, incorrect in 7 and reasonable in 12 patients.

The first group had a reducded number and duration of hospital admissions and also improved quality of life. With this remote monitoring system 80% of CRI patients reported they were more/much more supported and 33 patients (75%) would use this system in the future. 81% of asthmatic patients would also like to maintain this type of monitoring. The service was considered useful by the researchers. We concluded that home telemonitoring was a positive contribution to the management of chronic patients and raised awareness of it should be considered in the future.

Key-words: Asthma, severe chronic respiratory failure, ambulatory care, telemedicine.

 

 

Texto completo disponível apenas em PDF.

Full text only available in PDF format.

 

 

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1 Mestre em Patologia do Aparelho Respiratório pela Faculdade de Ciências Médicas da Universidade Nova de Lisboa. Assistente Hospitalar Graduada de Pneumologia. Unidade de Reabilitação Respiratória. Hospital de Pulido Valente, Lisboa / MA, Respiratory Apparatus Pathology, Lisbon University School of Medical Sciences. Consultant, Specialist, Pulmonology. Respiratory Rehabilitation Unit, Hospital Pulido Valente, Lisbon

2 Assistente Hospitalar Graduada de Pneumologia. Hospital do Espírito Santo. Évora / Consultant, Specialist, Pulmonology. Hospital do Espírito Santo. Évora

3 Enfermeira Graduada. Unidade de Reabilitação Respiratória. Hospital de Pulido Valente, Lisboa / Consultant Nurse, Respiratory Rehabilitation Unit, Hospital Pulido Valente, Lisbon

4 Professora Catedrática da Faculdade de Ciências Médicas da Universidade Nova de Lisboa. Coordenadora do Centro de Estudos de Doenças Crónicas da Fundação para a Ciência e Tecnologia. Chefe de Serviço de Pneumologia. Hospital de Pulido Valente, Lisboa / Cathedratic Professor, Lisbon Nova University School of Medical Sciences. Coordinator, Centre for the Study of Chronic Diseases, Science and Technology Foundation. Head, Pulmonology Service, Hospital Pulido Valente, Lisbon

 

 

Correspondência/Correspondence to:

Departamento de Pneumologia do Hospital de Pulido Valente (Directora: Prof. Doutora Maria João Marques Gomes)

Alameda das Linhas de Torres 117 – Lisboa

Serviço de Especialidades Médicas (Directora: Dra. Teresa Cardoso) do Hospital do Espírito Santo

Largo Senhor da Pobreza – 7000 -811 Évora.

 

Recebido para publicação/received for publication: 08.12.04

Aceite para publicação/accepted for publication: 09.01.12