Evaluation of a Connected Parenteral Pump for Patients Treated by Home Parenteral Nutrition (HPN).

Study Overview
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Brief Summary
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Patients requiring long-term home parenteral nutrition (HPN) suffer from chronic intestinal insufficiency. The causes of this syndrome can be either anatomical (extensive resection of the small bowel) or functional (occlusion, pseudo-occlusion, malabsorption). Consequences mean that patients are unable to cover their oral energy and / or hydroelectrolytic needs. As a result, these patients survive only through a nutritional support by the venous route (parenteral nutrition). However, this lifesaving therapy requires complex technological nutritional support issues at home, which will influence the personal life of the patients. At home, HPN therapy is performed by nutrition pumps providing a constant flow and able to detect anomalies. In this context, the development of connected systems that allow informations transmission could help patient's caregiving by the different persons involved in his follow-up (prescribing physicians, home support nurses, patients and relatives, manufacturers). The main objective of this study is to evaluate the performance of an end-to-end data transmission chain which integrates a nutrition pump connected to a medical IoT module (developped by Maatel) able to send information to an applicative layer (software interface PatHView2, developped by Orange Labs) via different transmission modes : LoRaWAN (Long Range Wide-area network), BLE (Bluetooth Low Energy), GSM LTE-M (Global System for Mobile Communications, Long Term Evolution - Machine Type Communication).

Official Title
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Evaluation of a Data Transmission Solution for Connected Nutrition Pump for Patients Treated by Home Parenteral Nutrition (HPN). Proof of Concept, Prospective, Monocentric, Non-randomized, and Open-label Study.

Conditions
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Parenteral Nutrition, Home

Intervention / Treatment
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* Device: Connected nutrition pump system


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age < 18 years Patient receiving a home parenteral nutrition (HPN) and followed by the Artificial Nutrition Service of the CHUGA Patient carrying out all his infusions at home during the month of use of the connected pump (constraint due to the LoRaWAn transmission mode) Patient affiliated to the French social security system or an equivalent system Patient who has signed consent form Exclusion Criteria: Presenting any other pathology or treatment that the physician may deem incompatible with this study Patient under exclusion period from another study Protected persons (patient concerned by articles L1121-5, L1121-6, L1121-8 of the French public health code)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Device Feasibility
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Connected nutrition pump system<br> | Device: Connected nutrition pump system<br>* For the patient, it consists of the installation of the connected pump at his home for a duration of one month. Infusion data and events will be continuously collected and transmitted by the 4 different modes (LoRaAN, BLE , GSM and multimodality).Transmitted data won't be used to change the follow up of the patient. At the end of the month, patients will be solicited by an ergonomic engineer to complete a specific questionnaire in order to evaluate the future acceptability of the proposed solution.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ratio of all data and anomaly events correctly transmitted from the connected infusion pump to the software interface. | Evaluate the ratio of data (volume administered with the perfusion cycles over 24 hours; duration, velocity rate and mode of the perfusions) and events (occlusion of the venous route and presence of bubble in the infusion line) correctly transmitted in different transmission modalities (LoRaWan, BLE+GSM, GSM LTE-M, multimodality) from the connected infusion pump to the software interface. | 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Volume of all data and anomaly events correctly transmitted from the nutrition pump to the software interface, compared to the volume of data to be transmitted. | Evaluate the ratio of all data (volume administered with the perfusion cycles over 24 hours; duration, velocity rate and mode of the perfusions) and events (occlusion of the venous route and presence of bubble in the infusion line) correctly transmitted in terms of volume using different transmission modalities (LoRaWan, BLE+GSM, GSM LTE-M, multimodality), from the connected infusion pump to the software interface. | 1 month | 
| Type and variable (value / field / date / time) for data and events from extracted files : - from the pump before the IoT module; - from the software interface. | Evaluate the ratio of each data type (volume administered with the perfusion cycles over 24 hours; duration, velocity rate and mode of the perfusions) and events (technical notifications of system use) correctly transmitted through the four transmission modalities (LoRaWan, BLE+GSM, GSM LTE-M, multimodality), from the connected infusion pump to the software interface. This target will be verified if the proportion of the main target is < 98%. | 1 month | 
| Frequency and typology of problems encountered. | Descriptive analysis of the problems encountered. | 1 month | 
| - Quantitative evaluation: number of cases in which the physician would have changed the patient follow-up over the entire study ; - Qualitative evaluation: nature of the follow-up change (no change, delayed change, immediate change). | Quantitative and qualitative evaluation of the proposed solution (software interface) in terms of medical reasoning help on the potential improvement of patient follow-up (i.e. compliance with a prescription). | 1 month | 
| Analysis of the efficacy, the efficiency, the difficulties and usage errors of the software interface by the medical team according to specific scenarios tests performed with an ergonomist (with voice and screen recording). | Evaluate the usability of the software interface by the medical team (physicians, nurses, ...). | 1 month | 
| Customised hetero-questionnaire at the end study visit. | Assess the acceptability of the proposed solution (connected pump) by the patient. | 1 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Connected feeding pump, Reduction of costs due to late management of complications, Patients quality of life improvement, Clinical management of patients' pathology improvement