Feasibility study: home telemonitoring for patients with lung cancer in a mountainous rural area.

PURPOSE/
OBJECTIVES: To explore the feasibility of rural home telemonitoring for patients with lung cancer.
DESIGN: Exploratory, descriptive, observational.
SETTING: Patient homes within a 75-mile radius of the study hospital in West Virginia. SAMPLE: 10 patients hospitalized with lung cancer as a primary or secondary-related diagnosis.
METHODS: Data included referral and demographics, chart reviews, and clinical data collected using a HomMed telemonitor. Five patients received usual care after discharge; five had telemonitors set up at home for 14 days with daily phone calls for nurse coaching; mid- and end-study data were collected by phone and in homes through two months. MAIN RESEARCH VARIABLES: Enrollment and retention characteristics, physiologic (e.g., temperature, pulse, blood pressure, weight, O2 saturation) and 10 symptom datapoints, patient and family telemonitor satisfaction.
FINDINGS: Of 45 referred patients, only 10 consented; 1 of 5 usual care and 3 of 5 monitored patients completed the entire study. Telemonitored data transmission was feasible in rural areas with high satisfaction; symptom data and physiologic data were inconsistent but characteristic of lung cancer.
CONCLUSIONS: Challenges included environment, culture, technology, and overall enrollment and retention. Physiologic and symptom changes were important data for nurse coaching on risks, symptom management, and clinician contact. IMPLICATIONS FOR NURSING: Enrollment and retention in cancer research warrants additional study. Daily monitoring is feasible and important in risk assessment, but length of time to monitor signs and symptoms, which changed rapidly, is unclear. Symptom changes were useful as proxy indicators for physiologic changes, so risk outcomes may be assessable by phone for patient self-management coaching by nurses.