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. 2025 Aug 19.
doi: 10.1007/s10877-025-01343-6. Online ahead of print.

Wireless patches for continuous vital sign monitoring, symptoms and medication at the end-of-life in the palliative care unit: A prospective observational study

Theresa Tenge  1   2   3 , Sebastian Reekers  4 , Oliver Maier  5 , Manuela Schallenburger  4 , Yann-Nicolas Batzler  4   6 , Marc Stefaniak  4 , Jacqueline Schwartz  4 , Alexandra Stroda  7 , René M Pembele  7 , Sebastian Roth  7 , Bahne H Bahners  8 , Guanqing Chen  9 , Maximilian S Schaefer  7   9 , Christian Jung  5 , Martin Neukirchen  4   7
Affiliations

Wireless patches for continuous vital sign monitoring, symptoms and medication at the end-of-life in the palliative care unit: A prospective observational study

Theresa Tenge et al. J Clin Monit Comput. .

Abstract

Vital sign monitoring in palliative care could support symptom management and prediction, though its utility at the end-of-life remains critically discussed. This study aims to test a wireless device for continuous vital sign monitoring at the end-of-life. This prospective observational study included adult terminal care patients in the palliative care unit at a tertiary-care hospital (05/2023-03/2024). Continuous monitoring of heart rate (HR in beats/minute, bpm), respiratory rate, and temperature was conducted using VitalPatches (MediBioSense). Patient demographics, medications, and symptoms were further recorded. Linear mixed-effects models were applied for analyses. 30 patients (median age 70, 53.3% female, 90% with cancer) were included. Median patch duration was 88 h (IQR 35-153). Symptom load increased until death (p = 0.004), with weakness and impaired vigilance being prominent. From patch start to end, opioid use rose from 80 to 100% (p = 0.010), and benzodiazepine use from 50 to 80% (p = 0.015). All vital signs increased in daily and hourly intervals. Compared to three days prior, the HR increased as death approached: 3.70 bpm (-2 days, p < 0.001), 7.64 bpm (-1 day, p < 0.001), and 12.26 bpm (day of death, p < 0.001). Pain correlated with HR (r = 0.32, p < 0.001), and a 5 bpm HR increase over the previous 24 h was associated with imminent death within the following 24 h. Continuous vital sign monitoring in palliative care using VitalPatches is feasible and depicts vital sign changes at the end-of-life. A positive correlation of HR with pain was detected. These observations provide a rationale for larger studies investigating their relevance for life time prediction as well as symptom detection and management.

Keywords: Death; Monitoring, physiologic; Observational study; Palliative care; Prospective studies; Terminal care; Vital signs; Wearable electronic devices.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: This study was performed in line with the principles of the Declaration of Helsinki. All participants or their legal representatives gave written informed consent before enrolment. The study protocol and supporting documentation was approved by the local ethics committee (protocol number: 2022 − 1981_1, March 18th 2023). Data management and sharing: The data related to this study is maintained and managed according to organizational guidelines and ethical regulations. In the interest of patient confidentiality and anonymity, this information will not be made publicly available. Requests for further information can be directed to the corresponding author.

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