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Remote Home Monitoring Acute Pancreatitis (REMAP)

Primary Purpose

Acute Pancreatitis, Telemedicine, Healthdot

Status
Not yet recruiting
Phase
Not Applicable
Locations
Netherlands
Study Type
Interventional
Intervention
Early discharge with remote home monitoring.
Sponsored by
Rijnstate Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Acute Pancreatitis

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Have 2 out of 3 revised Atlanta criteria for pancreatitis:

    • Abdominal pain consistent with acute pancreatitis
    • Serum lipase ≥ 3x upper limit normal (> 159 U/l)
    • Typical pancreatic abnormalities on imaging (ultrasound, CT or MRI)
  • First episode of acute pancreatitis or a prior pancreatitis more than 3 months ago.
  • Age ≥18 years, both men and women.
  • Able and willing to provide written informed consent.
  • In possession of a working (smart)phone on which patient can be reached for the duration of participation (30 days).

Exclusion Criteria:

  • Chronic pancreatitis according to M-ANNHEIM criteria (20).
  • Signs of severe pancreatitis at the moment of admission to the GE ward:

    • Serum CRP > 150 mg/l
    • More than one SIRS criteria:

      • temperature < 36◦C or > 38◦C
      • heart rate > 90/min
      • respiratory rate >20/min
      • leucocytes < 4x/109l or > 12x109/l
  • MEWS (Modified Early Warning Score) ≥6 or in need of ICU admission
  • Living alone or in an institution (e.g. psychiatric ward or nursing home)
  • Known sensitivity to medical adhesives
  • Known pregnancy
  • Have one or more of the following comorbidities:

    • Heart failure (NYHA class III or IV)
    • COPD (Gold III-IV)
    • Kidney disease (>G3b) and/or kidney replacement therapy
    • Currently undergoing oncological treatment
    • Use of immunosuppressants
    • Dysregulated or poorly controlled insulin dependent diabetes
    • Morbid obesity (BMI>35 kg/m2)
    • Implantable Cardioverter Defibrillator (ICD) or Pacemaker

Sites / Locations

  • Rijnstate Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Early discharge with remote home monitoring.

Arm Description

Patients are discharged early Patients receive remote home monitoring using a wearable sensor and a smartphone app. Patients fill in a satisfaction questionnaire

Outcomes

Primary Outcome Measures

Incidence (%) of unplanned hospital readmissions.
To determine the feasibility of novel care pathway
2. Incidence (%) of pancreatitis related complications. These complications include necrotizing pancreatitis, infection, pseudocysts, new onset diabetes, recurrence of pancreatitis, cholecystitis or cholangitis.
To determine the feasibility of novel care pathway
3. Mortality (%) of patients discharged home with remote monitoring.
To determine the feasibility of novel care pathway

Secondary Outcome Measures

Length of stay in the hospital
The amount of extra contacts between VMC-nurse or physician and the patient, in addition to the usual call once per day as documented in the smartphone app.
The amount of laboratory or imaging tests
All bloodtests and imaging tests (US, MRI and CT-scan will be documented)
Amount of adjustments in analgesics needed during home monitoring

Full Information

First Posted
August 8, 2022
Last Updated
August 11, 2022
Sponsor
Rijnstate Hospital
Collaborators
University of Twente, Philips Research Eindhoven
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1. Study Identification

Unique Protocol Identification Number
NCT05501314
Brief Title
Remote Home Monitoring Acute Pancreatitis
Acronym
REMAP
Official Title
Remote Home Monitoring of Patients With a Predicted Mild Acute Pancreatitis - A Feasibility Study (REMAP)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
October 2022 (Anticipated)
Primary Completion Date
October 2024 (Anticipated)
Study Completion Date
April 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Rijnstate Hospital
Collaborators
University of Twente, Philips Research Eindhoven

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Acute pancreatitis is an inflammation of the pancreas which causes abdominal pain and is the most common gastro-intestinal reason for acute hospitalization in Western countries. Because care for a mild acute pancreatitis is supportive, early discharge of patients with a predicted mild course of acute pancreatitis might be safe with the use of remote home monitoring. This might reduce the demand for hospital beds and allow patients to benefit from recovering in their home environment. Therefore, the aim of this study is to assess the feasibility of a novel care pathway in which patients with a predicted mild course of acute pancreatitis are discharged early with remote home monitoring.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Pancreatitis, Telemedicine, Healthdot, Patient Discharge, Monitoring

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
Feasibility study
Masking
None (Open Label)
Allocation
N/A
Enrollment
70 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Early discharge with remote home monitoring.
Arm Type
Experimental
Arm Description
Patients are discharged early Patients receive remote home monitoring using a wearable sensor and a smartphone app. Patients fill in a satisfaction questionnaire
Intervention Type
Other
Intervention Name(s)
Early discharge with remote home monitoring.
Intervention Description
After at least 48 hours of hospital admission, patients are discharged early with the use of remote home monitoring. During home monitoring, heartrate, respiratory rate, posture and movement are monitored every 5 minutes for at least 4 days, using a wearable sensor. Core temperature is monitored using an ear thermometer. Patients are contacted once per day by a nurse from the Virtual Monitoring Centre (VMC) to assess pancreatitis related complaints, intake of fluids and food, pain and the use of analgesics. Patients are asked to provide information to the hospital using a smartphone app.
Primary Outcome Measure Information:
Title
Incidence (%) of unplanned hospital readmissions.
Description
To determine the feasibility of novel care pathway
Time Frame
Within 30 days of discharge
Title
2. Incidence (%) of pancreatitis related complications. These complications include necrotizing pancreatitis, infection, pseudocysts, new onset diabetes, recurrence of pancreatitis, cholecystitis or cholangitis.
Description
To determine the feasibility of novel care pathway
Time Frame
Within 30 days of discharge
Title
3. Mortality (%) of patients discharged home with remote monitoring.
Description
To determine the feasibility of novel care pathway
Time Frame
Within 30 days of discharge
Secondary Outcome Measure Information:
Title
Length of stay in the hospital
Time Frame
Within 30 days of discharge.
Title
The amount of extra contacts between VMC-nurse or physician and the patient, in addition to the usual call once per day as documented in the smartphone app.
Time Frame
Within 30 days of discharge
Title
The amount of laboratory or imaging tests
Description
All bloodtests and imaging tests (US, MRI and CT-scan will be documented)
Time Frame
Within 30 days of discharge
Title
Amount of adjustments in analgesics needed during home monitoring
Time Frame
Within 30 days of discharge
Other Pre-specified Outcome Measures:
Title
Patient satisfaction is assessed using a satisfaction questionnaire
Description
Using a combination of two validated questionnaires
Time Frame
After 14 days of discharge.
Title
Overall costs of treatment
Time Frame
Within 30 days of discharge

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Have 2 out of 3 revised Atlanta criteria for pancreatitis: Abdominal pain consistent with acute pancreatitis Serum lipase ≥ 3x upper limit normal (> 159 U/l) Typical pancreatic abnormalities on imaging (ultrasound, CT or MRI) First episode of acute pancreatitis or a prior pancreatitis more than 3 months ago. Age ≥18 years, both men and women. Able and willing to provide written informed consent. In possession of a working (smart)phone on which patient can be reached for the duration of participation (30 days). Exclusion Criteria: Chronic pancreatitis according to M-ANNHEIM criteria (20). Signs of severe pancreatitis at the moment of admission to the GE ward: Serum CRP > 150 mg/l More than one SIRS criteria: temperature < 36◦C or > 38◦C heart rate > 90/min respiratory rate >20/min leucocytes < 4x/109l or > 12x109/l MEWS (Modified Early Warning Score) ≥6 or in need of ICU admission Living alone or in an institution (e.g. psychiatric ward or nursing home) Known sensitivity to medical adhesives Known pregnancy Have one or more of the following comorbidities: Heart failure (NYHA class III or IV) COPD (Gold III-IV) Kidney disease (>G3b) and/or kidney replacement therapy Currently undergoing oncological treatment Use of immunosuppressants Dysregulated or poorly controlled insulin dependent diabetes Morbid obesity (BMI>35 kg/m2) Implantable Cardioverter Defibrillator (ICD) or Pacemaker
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
C.M.J. Doggen, prof. dr.
Phone
+31880056042
Email
REMAPstudy@rijnstate.nl
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
C.M.J. Doggen, prof. dr.
Organizational Affiliation
Rijnstate Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Rijnstate Hospital
City
Arnhem
State/Province
Gelderland
ZIP/Postal Code
6815 AD
Country
Netherlands
Facility Contact:
First Name & Middle Initial & Last Name & Degree
C.M.J. Doggen, prof. dr.
Phone
+31880056042
First Name & Middle Initial & Last Name & Degree
N. Kant, drs.
First Name & Middle Initial & Last Name & Degree
B.W.M. Spanier, dr.

12. IPD Sharing Statement

Plan to Share IPD
Yes

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Remote Home Monitoring Acute Pancreatitis

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