THE ROLE OF SUBJECTIVE AND OBJECTIVE CRITERIA IN THE ASSESSMENT OF THE STATE OF PATIENTS WITH BRONCHOBSTRUCTIVE DISEASES IN REMOTE MONITORING CONDITIONS
Authors:   Russian research center of surgery named after academician B.V. Petrovsky, SHUBINA KSENIIA M. , MISHLANOV VITALIY J. ,   Perm State Medical University, NIKITIN IGOR G. ,   Russian National Research Medical University, BEKKER KSENIIA N. ,   Perm State Medical University, EMELKINA VERONIKA V. ,   Perm State Medical University, SHUBIN IGOR V. ,   Russian National Research Medical University
Published: October 2023

Introduction. Wearable or home electronic devices with the function of transmitting information at a distance are used for the purpose of remote dynamic monitoring of the condition of patients. Aim. To determine the effectiveness of the use of "new" criteria for assessing the health status of patients with broncho-obstructive diseases in order to monitor remotely. Material and methods. 28 patients with broncho-obstructive diseases who were admitted for inpatient treatment were examined. Most of them had comorbidities, mainly cardiovascular pathology. A general clinical examination and special research methods were performed: an interactive survey using the respiratory module of the Electronic Polyclinic program, remote monitoring of vital signs using a smart watch and a mobile application for recording and transmitting information, a 6-minute walk test with simultaneous recording of vital signs with using a smart watch, a questionnaire and a scale for assessing the usability of the System usability scale system. The analysis of the results was performed by using the Statistica 13.0 software package. Results and discussion. Interactive survey corresponded to the severity of dyspnea according to the mMRC and Borg scales. The 6-minute walk test showed a significant limitation of physical activity and an increase in heart rate. The deep sleep phase has been limited. The CRP index averaged 7.78±8.48 µg/l. More than 85% of patients expressed their willingness to continue observation. The results of the correlation analysis demonstrated a direct relationship with the patient's physical activity assessment and the results of the 6-minute walk test, and an inverse relationship with the 6-minute walk test result and the patients' age, severity of respiratory failure and CRP concentration. The duration of deep sleep is inversely correlated with the SpO2 value. Our studies made it possible to compare the obtained data with the results of traditional methods of examining a patient, to confirm the position that the physical activity of a patient with broncho-obstructive disease is connected with indicators of the function of external respiration, and also that the total duration of sleep of COPD patients mainly consists of light sleep with a decrease in the duration of deep sleep. An inverse relationship was found with the duration of deep sleep and the concentration of CRP and the value of SpO2. The described monitoring system allows you to timely adjust the treatment regimen, reduce the number of hospitalizations, the risk of exacerbation or death.Conclusion. Additional instrumental control of vital parameters increases the efficiency of the system of long-term remote monitoring of patients with broncho-obstructive diseases. the indicators represent the severity of the symptoms of the disease and the degree of violations of the indicators of the function of external respiration.