Remote Patient Monitoring Research

Remote Patient Monitoring via Smartphone

Telehealth is finally beginning to show real adoption with the move to outcome based care.

Any number of virtual care platforms have now thrown their hat in the ring to attempt to make patient communications as easy as regular calls. 

Smartphone monitoring seems like a good option for physicians and patients alike. The literature on smartphone monitoring is limited, but it shows potential for clinical use.

In a recent study by Dalla Pozza et al. (2017), the researchers explored patient monitoring after treatment, which asked their patients to take photos of post-op procedure as they were instructed by their surgeons. Patients were asked to send photos of the front and side views of their face to send to the surgeons.

Out of the original 57 in the sample, only fifty followed-up with post-operative photos.

The following procedures performed were:

• (32) Facelifts, platysmaplasty, submental lipectomy;
• (14) Upper and lower blerophaplasty;
• (11) Fat injections

After treatment, three patients experienced complications early on. The patient in the study still preferred the usual face to face consultation, but the researchers mention that most of their sample were older patients, and were not able to adapt to some applications used for the study.

A similar study also examined the use of patient monitoring via smartphone. Chee et al. (2016) focused more on laser resurfacing on the dermatological aspect of it. Their study provided insight on the patient’s use of smartphone monitoring. There were 123 patients in the study, and having done the procedure around 12% had adverse events after it. Due to the complications, the dermatologist treated them the day after. Numbers dwindled as only a few answered the follow-up survey leaving only a few to report the smartphone review had good effects on them.

According to the authors, 95% out of the 24 who completed their survey felt at ease with the teledermatology process.

There is the risk of violating HIPAA and HITECH. In the first study, the researchers mention that limitation as patients may not have a HIPAA-compliant smartphone to send images or details of their condition. In this case, physicians have the responsibility to make sure their images are secure. In the second study, patients were wary with sharing their photos as well.

To learn more you might take a look at the scores from the KLAS 2017 Virtual Care Platform Report in which a dozen or so telehealth platforms (TruClinic, American Wellness, InTouch, etc.) were scored across a number of criteria.

OTC Vitamin Lowers Non-Melanoma Skin Cancer Risk

Can a simple vitamin taken in conjunction with sensible sun protection significantly lower the risk of common, non-melanoma skin cancer in high-risk patients?

A recent study completed at the University of Sydney and Royal Prince Alfred Hospital in Australia supports this claim. Senior author and professor of dermatology Dr. Diona Damian found evidence that skin cancers may be reduced with a year of treatment of nicotinamide.

A type of vitamin B3, nicotinamide is considered to be safe and affordable and is available in most countries as an over-the-counter drug. The study showed that nicotinamide was very well tolerated with no difference in adverse events, blood results, or blood pressure.

Nicotinamide differs from nicotinic acid and niacin, two other forms of vitamin B3. Nicotonic acid commonly causes headaches, flushing, and low blood pressure, but these side effects are not seen with nicotinamide.

Previous studies suggest that nicotinamide enhances the repair of DNA in skin cells damaged by sunlight. Additionally, nicotinamide appears to protect the skin's immune system from UV radiation by providing skin cells an extra energy boost when they are in repair-mode after sun exposure.

Skin cancer is known to be the most common form of cancer in fair-skinned populations in the world and it is considered to be four times as common as all other cancers combined. More than half of the population of Australia is affected by non-melanoma skin cancer.

Non-melanoma skin cancer is caused by sun exposure. The 386 participants involved in Dr. Damian’s study had a history of skin cancer, increasing their risk for additional skin cancers.

The patients were asked to take the pill twice-daily pill for a period of 12 months. Nicotinamide reduced the incidence of new non-melanoma skin cancers by 23%, relative to placebo controls, and cut the incidence of pre-cancerous sun spots by around 15%.

The average number of actinic keratoses (pre-cancerous sun spots) in the nicotinamide group was consistently lower during treatment, ranging from an 11% reduction at three months, to a 20% reduction at nine months.

Dr. Damian hopes that these findings can be immediately translated into clinical practice. However, she adds that people who are at high risk of skin cancer still need to practice sun safe behavior, use sunscreens, and have regular check-ups with their doctors.

More about this on: http://www.sciencedaily.com/releases/2015/10/151021185104.htm

High Dissatisfaction among Patients with Atopic Dermatitis: Opportunity for New Market Entrants

Atopic dermatitis, also known as eczema, appears most commonly in one-year old children, and about half of these children will have them when they become adults. Sadly, research reveals a very high dissatisfaction among adult patients of the treatments available for atopic dermatitis (AD). On the other hand, this is a good news for new entrants in the market.

The research done by GfK Disease Atlas on atopic dermatitis covered eight countries, over 4,000 pediatric and adult atopic dermatitis patients, and over 800 physicians. Results reveal that 6 out of 10 patients experiencing moderate to severe atopic dermatitis who were treated with topical steroids are not satisfied with the results.

This is amidst the the fact that about 92% of them said that their doctors explained what is expected from the treatment. Four out of 10 of doctors also expressed their dissatisfaction. Topical steroids are used mainly to reduce the swelling and inflammation in affected areas and control eczema.

There is a lack of options available for patients, making them repeat the same treatment options.This is the reason why GfK Immunology and Dermatology Therapy Director Alison Rose said that there is a huge potential for new players to enter the market and provide with other therapy options.

According to the American Academy of Dermatology, atopic dermatitis cannot be cured but it can be controlled. This is done by preventing AD from getting worse, calming the skin and relieving pain and itch, preventing infections, and stopping the skin from thickening.

Further, according to the AAD website, there is no way to determine if AD will ever go away or it will be a lifelong disease, however, it gets milder with age. Treatments, therefore, are very much important in preventing AD from getting worse and relieving a patient's discomfort.

Read more on: http://www.gfk.com/news-and-events/press-room/press-releases/pages/dissatisfaction-in-atopic-dermatitis-treatment.aspx https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/a---d/atopic-dermatitis