The use of wearable sensor technology to enhance supportive care in hospitalized palliative patients (Support trial): a prospective preliminary pilot study.

Abstract

Background: Continuous monitoring of vital parameters using wearable devices offers potential benefits in palliative care, such as early detection of clinical deterioration and improving symptom management. However, evidence supporting their feasibility and utility in hospitalized palliative care patients remains scarce.

Methods: This prospective pilot study aimed to evaluate the feasibility of continuous vital sign monitoring in hospitalized palliative care patients using wrist-worn and chest-wall devices. The study was conducted from October 2023 to November 2024 and included hospitalized patients at a university hospital. Eligible participants were required to provide written informed consent. Patients were monitored for up to 30 days or until discharge or death. Data acquisition focused on the quantity and quality of recorded parameters, including heart rate, respiratory rate, and oxygen saturation, as well as advanced hemodynamic variables. Challenges in recruitment, device performance, and data reliability were assessed.

Results: A total of 275 patients were screened, with 263 excluded for not meeting eligibility criteria. Of the nine patients who provided written informed consent, two withdrew consent before study interventions, leaving seven participants. Among these, one patient completed the maximum study duration, three were discharged to outpatient care, and three died during hospitalization. Wrist-worn devices yielded valid data for 61.5% of the monitored time (median: 57.6%; range: 20.1-78.3%), while chest-wall devices achieved 55.2% (median: 62.3%; range: 3.6-100%). Heart rate and respiratory rate showed excellent reliability (> 99% data availability), whereas oxygen saturation exhibited poor performance (45.1%). The interval between the last recorded device measurement and time of death ranged from 0 to 25 min. Recruitment challenges, including strict consent requirements, resulted in premature study termination, as achieving the target sample size of 25 patients was deemed unfeasible.

Conclusion: This pilot study demonstrates the potential of continuous monitoring technologies in palliative care, but inconsistent data availability limits the ability to recommend their routine use at this stage. Despite these challenges, the promising results highlight the need for further studies to improve device reliability and explore the broader applicability of this technology in palliative care settings.