The following is a summary of the “Evaluation of CirrhoCare® – a digital health solution for home management of individuals with cirrhosis,” published in the January 2023 issue of Hepatology by Kazankov, et al.
After experiencing acute decompensation, patients with cirrhosis are at significant risk for developing additional difficulties after being released from the hospital. This research aimed to evaluate the usefulness of CirrhoCare® for remote care of patients with acutely decompensated cirrhosis. After experiencing acute decompensation, those with cirrhosis were followed with CirrhoCare® and compared to matched controls who received normal follow-up care simultaneously. A smartphone app called CirrhoCare® was used in conjunction with a variety of commercially available monitoring devices to keep track of things like vital signs, weight, percentage of body water, mental acuity (using the CyberLiver Animal Recognition Test [CL-ART] app), subjective feelings of well-being, and dietary and alcoholic beverage consumption.
Patients and doctors could talk to each other through the app. Decisions made with the help of CirrhoCare® were evaluated for accuracy by an independent external adjudicator. There was no statistically significant difference between the demographics of the 20 cirrhotics enrolled in CirrhoCare® and the 20 matched controls (mean age 59 ± 10 years, 14 male, alcohol-related cirrhosis [80%], mean model for end-stage liver disease–sodium [MELD-Na] score 16.1 ± 4.2). The average time between visits was 10.2 ± 2.4 weeks. About 15 participants read satisfactorily (more than four times per week), two read between twice and three times per week, and three read less than twice per week. The median answer in a usability survey was 9. The mean length of stay for 8 readmissions for 5 people managed with CirrhoCare® was 5 days (IQR 3.5-11), and no one needed to be hospitalized for more than 14 days.
There were 16 more patient contacts made thanks to the guidance of CirrhoCare®, and these interactions resulted in clinical treatments that halted the advancement of the disease. Adjudicators agreed that this was an appropriate use of the term. Among the controls, 13 readmissions occurred in 8 people, with a median length of stay of 7 days (IQR: 3-15 days) and 4 admissions lasting more than 14 days. As opposed to the lone unplanned paracentesis in the CirrhoCare® group, they underwent 6 of these procedures. As shown in this study, good participation and clinically relevant alerts to new decompensating events show that CirrhoCare® is practical for community care of people with decompensated cirrhosis. Larger controlled clinical trials are warranted because patients under CirrhoCare® management have shorter and fewer readmissions.
Source: sciencedirect.com/science/article/pii/S0168827822030665
