eHealth generated patient data in an outpatient setting after stem cell transplantations: a scoping review

Jolien Van Opstal
Persbericht

Betere overleving na stamceltransplantatie…dankzij je smartwatch?

Elk jaar ondergaan zo’n 1000 Belgen een levensreddende stamceltransplantatie, een behandeling voor verschillende bloed- en lymfeklierkankers of ernstige auto-immuun aandoeningen. Door middel van chemotherapie verwoest men eerst het immuunsysteem waarna men nieuwe stamcellen toedient om het immuunsysteem terug op te bouwen. Hoewel er de afgelopen decennia heel wat vooruitgang is geboekt, is één jaar later 30% van de patiënten overleden. Wie het wél overleeft, blijft vatbaar voor verschillende complicaties en ontwikkelt makkelijker chronische ziekten. Iedereen die ooit een stamceltransplantatie heeft ondergaan, heeft dan ook levenslang gespecialiseerde zorg nodig. Het coördineren van deze zorg en het tijdig opmerken van complicaties is een enorme uitdaging.

Een smartwatch, smartphone of computer kan hier het verschil maken! Het gebruik van elektronica en technologie binnen de zorg, ook wel “eHealth” genoemd, neemt de laatste jaren sterk toe en de mogelijke toepassingen vergroten zienderogen. Studente geneeskunde (KU Leuven) Jolien Van Opstal schreef haar masterscriptie over het gebruik van eHealth binnen het domein van de stamceltransplantatie. “Binnen verschillende geneeskundige domeinen wordt eHealth steeds vaker gebruikt voor patiëntenzorg, en met goede resultaten. Hoewel we studies in andere domeinen niet simpelweg kunnen transfereren naar stamceltransplantatie patiënten, opent deze evolutie wel interessante deuren om de complexe en langdurige zorg van deze patiënten eenvoudiger en beter te maken. Bijna iedereen heeft ondertussen en smartphone. Waarom zouden we die niet inschakelen om betere zorg te bieden aan onze patiënten?”

Aan de hand van een wetenschappelijke literatuurstudie onderzocht Van Opstal het huidige eHealth landschap binnen het domein van de stamceltransplantatie. Van Opstal: “Hoewel er veel te doen is rond eHealth, was er binnen het domein van de stamceltransplantatie nog nooit een studie gepubliceerd die alle wetenschappelijke studies bundelt en kijkt hoever de wetenschap eigenlijk staat.” De resultaten van Van Opstal’s literatuurstudie werden onlangs gepubliceerd in het internationaal wetenschappelijke tijdschrift “Transplantation and Cellular Therapy”. Opvallend is de sterke toename van wetenschappelijke literatuur over het gebruik van eHealth. In 2015 waren er wereldwijd nog maar 6 artikels over eHealth gebruik na stamceltransplantaties, in 2021 steeg dit aantal naar 22. “Een duidelijke trend”, volgens Van Opstal. “De recente ‘boom’ in aantal studies toont de sterke interesse voor eHealth gebruik binnen dit domein.” Meer dan de helft van de studies focust op “patient-reported outcomes”. Hierbij vullen patiënten op regelmatige tijdstippen online vragenlijsten in over hun fysieke symptomen, maar ook bijvoorbeeld over hun mentaal welzijn. Het behandelteam van de patiënt bestudeert vervolgens de resultaten, zo krijgt men beter zicht op hoe het met de patiënt gaat. Van Opstal: “Als een patiënt tijdens zo’n vragenlijst aangeeft dat hij/zij de laatste tijd sneller buiten adem is, kan dit wijzen op “graft-versus-host disease” van de longen, een gevreesde complicatie. Door dit via vragenlijsten op te pikken, kunnen we de patiënt vroeger doorverwijzen naar de longarts en kunnen we sneller starten met een behandeling.”

De studie toont ook aan dat men steeds vaker gebruik maakt van technische apparaten die de klinische parameters van patiënten monitoren. Een voorbeeld is het gebruik van een draagbare longfunctiemeter die patiënten thuis gebruiken. De gegevens worden automatisch doorgestuurd naar het patiëntendossier en wanneer bepaalde waarden zorgwekkend zijn, wordt dit automatisch opgepikt. De eerste studies met deze longfunctiemeter tonen alvast aan dat het mogelijk is om longcomplicaties sneller op te merken. Andere artikels bespreken het gebruik van een bloeddrukmeter, thermometer of weegschaal die data automatisch registeren in het patiëntendossier. Ook een smartwatch kan gekoppeld worden met het patiëntendossier. Van Opstal: “Mijn co-promotor, Dr. Anthony Sung van Duke University, gaf me een mooi voorbeeld van een patiënt die dagelijks een stappenteller gebruikte en een longcomplicatie ontwikkelde. Wanneer we terugkeken naar de data van zijn stappenteller zagen we een duidelijke afname van het aantal stappen in de maanden voorafgaand aan de diagnose. Als we deze data op een gestandaardiseerde manier zouden kunnen gebruiken en opnemen in het patiëntendossier kunnen we complicaties en problemen ongetwijfeld sneller opmerken en behandelen.”

Hoewel de studie van Van Opstal aantoont dat er een toegenomen interesse en heel wat mogelijkheden zijn met betrekking tot eHealth, zijn er nog obstakels. Zo is er tot nu toe geen enkele studie die kijkt naar de kosteneffectiviteit en de mogelijke nadelen van eHealth gebruik. Momenteel ontbreekt het ook aan grote studies die een duidelijk effect op de gezondheidsuitkomsten van patiënten in kaart brengt. Van Opstal: “Mijn masterscriptie toont aan dat eHealth enorm veel potentieel heeft maar dat verder ontwikkelwerk zeker nog nodig is alvorens men het in de dagelijkse praktijk kan gebruiken. Dat staat niet in de weg dat ik er alvast van overtuigd ben dat het gebruik van je smartwatch in de toekomst je overlevingskansen na een stamceltransplantatie zal verhogen.”

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Universiteit of Hogeschool
Master in de Geneeskunde
Publicatiejaar
2022
Promotor(en)
Hélène Schoemans (promotor), Anthony Sung (co-promotor)
Kernwoorden
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