A t-shirt that monitors a patient’s vitals after urological surgery for cancer could help people return from hospital sooner to recover at home. The device, worn for around two weeks under clothes for three-hour windows each day, enabled patients to feel safer and more reassured than a control group in a pilot study of 70 individuals.
The results are presented this weekend at the European Association of Urology (EAU) Congress in Madrid.
Telemedicine in medical practice allows patients and clinicians to maintain contact remotely so that care, interventions and monitoring can continue from the comfort of a patient’s own home. Antonio L Pastore, Associate Professor of Urology, Sapienza University of Rome, and colleagues wanted to see if their patients could be discharged earlier than is currently standard, following robot-assisted urological surgery for cancer.
The team worked with a company specialising in telemonitoring, LET's Webearable Solutions, and designed a light t-shirt with sensors that monitor ECG, respiratory and heart rate, body temperature and more. The wearable technology sends data to an app and web-based software.
In a control group, patients were discharged as normal, three to five days after surgery. In the ‘wearable’ group they were discharged 24–36 hours earlier, two to four days after surgery, with a t-shirt to monitor vital parameters, including blood pressure, pulse rate, saturation, and blood glucose. The wearable group were fully briefed on how the device worked and asked to wear it for certain periods during the day, between 7–10 am, 2–5 pm, and 7–10 pm.
Antonio Pastore says: “The t-shirt we gave to patients differs from smartwatches and other wearables. It can reveal more data, including electrolytes, which we need to continue to monitor after bladder surgery as they can reveal mineral imbalances that lead to serious complications.”
In the control group, eight patients (26%) accessed the hospital before their scheduled follow-up compared with two patients, just 6%, in the wearable group. Monitoring by the t-shirt also detected the onset of cardiological conditions in five patients, allowing for early diagnosis and treatment.
The average remote monitoring period was 13.5 days, and the overall satisfaction rate among patients in this group was 90%. Only a few patients, 10%, had trouble understanding the telemedicine-based instructions, 87% found it effective and encouraging.
Antonio Pastore says: “Our patients found the t-shirt easy to use and over 90% reported it allowed them to feel safe and cared for while recuperating at home. In Italy, where standard discharge time after this type of robotic-assisted urological surgery can be at least 72 hours, being able to allow patients home sooner improves their quality of life as they feel more comfortable in their own environment, and it means we can free up hospital beds too.”
Commenting on the study, Professor Maarten Albersen, Urologist at UZ Leuven, Belgium, and EAU Scientific Congress Office Chair, said, “This sensory t-shirt appears to be a promising remote monitoring technology for helping patients to recover well at home after robotic-assisted urological surgery. The trial is early stage, but the insights are very interesting, particularly since patients strongly accepted the wearable and it was able to detect complications in real-time and reduce unnecessary rehospitalisations.”
“Given the small size and preliminary nature of the trial, before we can see this sort of wearable in clinical practice more data is needed on its ability to support earlier discharge from hospital, and its true impact on outcomes and cost-effectiveness.”
A study into the cost-effectiveness of the technology is currently underway by the researchers.