The methodology of remote monitoring of patients with urinary stone disease: development and primary approbation


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Abstract

Introduction. Urolithiasis is a clinically and socially significant disease that requires long-term follow-up in order to prevent stone recurrence. Currently, telemedicine consultations in the "patient-doctor" format are actively used in urology, however, the methodology, technological base and assessment of the efficiency of remote monitoring of the patient's health status are virtually not developed. Aim. To provide basics for the methodology of remote monitoring of patients with urolithiasis for detailed comprehensive examination and comprehensive metaphylaxis of recurrent stone formation. Materials and methods. A comprehensive clinical examination was carried out on the basis of the Institute of Urology and Human Reproductive Health, the National Medical Research Center on Urology and the Institute of Digital Medicine of FGAOU VO I.M. Sechenov First Moscow State Medical University during the period from 1st February to 1st December 2020. A total of 30 patients with urolithiasis were included in the study. Remote monitoring of health status was carried out using a portable analyzer "ETTA AMP-01" on dipstick. Data transmission was performed through a mobile application, which is part of the "NetHealth" information system (www.nethealth.ru). The values and frequency of urine tests performed by the patient independently, as well as patient satisfaction and adherence to the monitoring technology were evaluated. Analytical, clinical, sociological and statistical research methods were used. Results. By systematizing published data and our own clinical experience, we have developed a model for remote monitoring of the health status of patients with urinary stone disease, which included a system of indications and contraindications, a program and an order of the monitoring, as well as a basic technological solution (medical devices and a hardware-software complex). In this study, median duration of remote monitoring was 168 days. According to the questionnaire, general positive assessment and desire to continue telemonitoring was seen in 100.0% of cases, while 86.7% of patients positively evaluated the technical accessibility and reliability of the system and 93.3% considered the quality and availability of medical care as high. Conclusion. A methodology for remote monitoring of patients with urolithiasis has been developed with the aim of preventing recurrent stone formation. There was a high adherence of patients to remote monitoring with a tendency to decrease in values after 4 and 6 months. During these periods, it is necessary to carry out routine consultations by the physician who appointed remote monitoring in order to continue the follow-up program. There was a high satisfaction of patients with remote monitoring, and they pointed out the quality and availability of urological care owing to telemedicine technologies.

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About the authors

G. S Lebedev

FGAOU VO I.M. Sechenov First Moscow State Medical University

Ph.D. in technologic sciences, Head ofthe Department of Information and Internet Technologies

I. A Shaderkin

FGAOU VO I.M. Sechenov First Moscow State Medical University

Ph.D., urologist, Head of the e-Health Laboratory at the Institute of Digital Medicine

M. A Gazimiev

FGAOU VO I.M. Sechenov First Moscow State Medical University

Ph.D., MD, professor, Director of National Medical Research Center of Urology on Urology, Deputy Director on Science of the Institute for Urology and Human Reproductive Health

V. I Rudenko

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: rudenko-vadim@rambler.ru
Ph.D, MD, professor at the Institute of Urology and Reproductive Health, methodologist of the Department of Monitoring of medical care of National Medical Research Center of Urology on Urology

I. V Dyakonov

FGAOU VO I.M. Sechenov First Moscow State Medical University

Ph.D., methodologist of the Department of Monitoring of medical care of National Medical Research Center of Urology on Urology

A. E Alfimov

FGAOU VO I.M. Sechenov First Moscow State Medical University

Ph.D., researcher of the e-Health Laboratory at the Institute of Digital Medicine

A. V Vladzimirsky

FGAOU VO I.M. Sechenov First Moscow State Medical University; GBUZ Scientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Department of Health

Ph.D., MD, professor of the Department of Information and Internet Technologies; Deputy Director on scientific work

A. M Gazimiev

FGAOU VO I.M. Sechenov First Moscow State Medical University

Email: arturilkin@gmail.com
6-year student

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