Home pulse oximetry monitoring during the COVID-19 pandemic: An assessment of patient engagement and compliance

Objectives

Patients with suspected COVID-19 remain at risk for clinical deterioration after discharge and may benefit from home oxygen saturation (SpO₂) monitoring using portable pulse oximeter devices. Our study aims to evaluate patient engagement and compliance with a home SpO₂ monitoring program.

Methods

This is a single center, prospective pilot study of patients being discharged from the ED or urgent care after evaluation of symptoms consistent with COVID-19. Subjects were given a portable pulse oximeter and instructed to obtain measurements at rest and with exertion twice daily for 14 days. Patients were contacted daily to collect recorded data. If attempts to contact the patient were unsuccessful for 3 consecutive days, patients were considered lost to follow up. The primary outcome of interest was patient engagement in the program which was defined as the percentage of patients that completed the 14-day study period, meaning they were not lost to follow up. Secondary outcomes included compliance with performing the SpO₂ readings. Patient compliance was calculated as a percentage of completed readings out of the total expected readings.

Results

Fifty patients were enrolled - 2 withdrew and 1 was a screen failure. Overall, engagement in the program was 46.8% with no significant difference between those who tested positive for SARS-CoV-2 versus those who tested negative (48.2% vs 45%, p = 0.831). Median compliance overall was 42.9% (IQR 22.22–78.57). Median compliance for the positive group was 50.0% (IQR 20–85.71) and 42.86% (IQR 22.92–76.44) for the negative group (p = 0.838).

Conclusion

Our study demonstrated that there was acceptable engagement and compliance in a 14-day home SpO₂ monitoring program. These results support the use of home pulse oximetry monitoring in a select group of mildly ill patients with suspected COVID-19.