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Randomized Controlled Trial
. 2023 Nov 30;73(737):e894-e902.
doi: 10.3399/BJGP.2023.0139. Print 2023 Dec.

Patients' and GPs' views and expectations of home monitoring with a pulse oximeter: a mixed-methods process evaluation of a pilot randomised controlled trial

Karin Smit  1 , Roderick P Venekamp  1 , Geert-Jan Geersing  1 , Frans H Rutten  1 , Lisette Schoonhoven  1 , Dorien Lm Zwart  1
Affiliations
Randomized Controlled Trial

Patients' and GPs' views and expectations of home monitoring with a pulse oximeter: a mixed-methods process evaluation of a pilot randomised controlled trial

Karin Smit et al. Br J Gen Pract. .

Abstract

Background: Research on how home monitoring with a pulse oximeter is executed and experienced by patients with an acute illness such as COVID-19 and their GPs is scarce.

Aim: To examine the process of structured home monitoring with a pulse oximeter for patients with COVID-19, their caregivers, and their GPs.

Design and setting: This was a mixed-method process evaluation alongside a pilot feasibility randomised controlled trial. Patients drawn from a general practice setting, with COVID-19, and aged ≥40 years with cardiovascular comorbidities were included.

Method: Quantitative trial data from 21 intervention group participants (age 63.2 years) were used, plus qualitative data from semi-structured interviews with 15 patients (age 62.9 years), eight informal caregivers, and 10 GPs.

Results: Adherence to the intervention was very high; 97.6% of protocolised peripheral oxygen saturation (SpO2) measurements in the first 14 days until admission to hospital were recorded (677/694, median daily per patient 2.7). Three identified themes from the interviews were: (a) user-friendliness of home monitoring: easy use of the pulse oximeter and patient preference of a three times daily measurement scheme; (b) patient empowerment: pulse oximeter use enhanced patient self-assurance and empowered patients and informal caregivers in disease management; and (c) added value to current clinical decision making. GPs perceived the pulse oximeter as a useful diagnostic tool and did not experience any additional workload. They felt more secure with remote monitoring with a pulse oximeter than only phone-based monitoring, but emphasised the need to keep an overall view on the patient's condition.

Conclusion: Structured home monitoring by pulse oximetry supports patients and their informal caregivers in managing, and GPs in monitoring, acute COVID-19 disease. It appears suitable for use in acutely ill patients in general practice.

Keywords: COVID-19; SARS-CoV-2; general practice; oximetry; pulse oximetry.

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Conflict of interest statement

The authors have declared no competing interests.

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