Improve patient satisfaction and reduce complications through eHealth – the eSwiss HPN study

Résumé fourni par la source

Background and objective: Patients who cannot meet their nutritional needs orally or enterally require parenteral nutrition (PN) with home parenteral nutrition (HPN) in patients needing long-term PN. While HPN improves quality of life, it carries risks like catheter-related complications, requiring close monitoring and multidisciplinary support. eHealth solutions, particularly videoconferencing, offer a promising approach to enhance patient care by improving accessibility and reducing hospital visits. The purpose of this study is to evaluate the satisfaction and effectiveness of eHealth in the management and quality assurance of therapy in patients receiving HPN. Methods: This prospective, multicenter pilot study was conducted in Switzerland in 2023. The study design was a comparative before-and-after study over eight months, four months before (retrospective) and four months after eHealth implementation. The after phase involved eHealth care, which included frequent, shorter interactions between patients and their treating physicians, as well as monitoring through the eSwissHPN App. Patients and physicians completed questionnaires to assess satisfaction (Client-Satisfaction-Questionnaire (CSQ-8) and Telehealth-Usability-Questionnaire (TUQ)) with the App and care at baseline and at the end of the intervention. In addition, physicians documented the occurrence of HPN-related complications. Four different questionnaires were used to assess satisfaction with the service, usability of the application, information technology (IT) skills and general health. Results: Out of a total of 15 patients, 11 patients from different clinics across the country were included in the final analysis of the study. Satisfaction with eHealth, measured using the CSQ8, yielded a mean score (SD) of 3.4 ± 0.7 for patients and 3.5 ± 0.6 for physicians, indicating high satisfaction. In the before phase, three manifest complications were reported by the physician, whereas in the after phase, only one complication was reported and arising clinical and device problems were prevented. Conclusion: In summary, monthly virtual consultations in HPN have proven to be a patient-centered, flexible, and cost-effective healthcare solution, with high levels of satisfaction reported by both patients and physicians. During the implementation phase, physicians reported fewer complications. In addition, emerging clinical and device issues were handled promptly, avoiding manifest complications. To confirm these promising results, further robust studies are needed.

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