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Remote symptom reporting systems may reduce waiting lists Hope for treatment
Digital systems for patients to monitor and report symptoms remotely may offer a solution to reduce outpatient waiting lists, according to a new review published by the Journal of the Royal Society of Medicine. The review, led by researchers from the Centre
for Patient Reported Outcomes Research (CPROR), Institute of Applied Health Research, at the University of Birmingham, looked at international examples of the use of electronic patient-reported outcome (ePRO) systems to triage clinical care. ePROs allow patients to fill out questionnaires at home or location of their choice, with the results sent back to the clinician in near real-time to use in clinical decision-making. Studies of various groups of patients, including those with epilepsy, sleep apnoea, type 1 diabetes, cancer, rheumatoid arthritis and HIV, were included in the review. In Denmark, Ambuflex – a generic ePRO system – has been used in over 40,000 patients across a range of chronic conditions, and has led to substantial reductions in outpatient appointments. In epilepsy clinics, the system led to reductions of up to 48% in in-person outpatient appointments. Lead author, Dr. Lee Aiyegbusi, associate
professor and deputy director at CPROR, said: “The use of PROs is well established in research settings to evaluate the effectiveness, cost-effectiveness and tolerability of interventions from a patient perspective. Clinicians are now interested in using patient-level symptom reporting for the clinical
for strokes linked to dementia
Two cheap and common drugs could be re- purposed as the first specific treatment for people who experience a type of stroke linked to nearly half of all dementias, according to the results of new research. A clinical trial run by the University of
management of individual patients in routine practice.” The review provides evidence to support the implementation of ePRO systems for outpatient care, including significant reductions in outpatient appointments without compromising patient outcomes or satisfaction with care. Dr. Aiyegbusi said: “ePROs for outpatient care could facilitate the tailoring of care to patient needs. Stable patients can be monitored remotely using ePROs, thereby avoiding unnecessary check- ups in outpatient clinics and associated costs, such as travel and time off work, without lowering the quality of treatment. This efficient use of scarce healthcare resources could free up outpatient clinics for patients with high symptom burden or concerning symptoms, so they can be seen more quickly.”
Nottingham and University of Edinburgh and funded by the British Heart Foundation has shown that isosorbide mononitrate and cilostazol, which are already used to treat other heart and circulatory diseases, can safely and effectively improve the debilitating outcomes people experience after lacunar stroke, particularly when they’re used in combination. The trial results were presented at the American Heart Association International Stroke Conference. After one year, participants that took both drugs were nearly 20% less likely to have problems with their thinking and memory compared to the group that did not take either drug. They were also more independent and reported a better quality of life. Those who took isosorbide mononitrate were also less likely to have had further strokes at one year. The drugs could be available as a treatment for lacunar strokes within five years, if the results are confirmed in further trials.
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