Patients’ Acceptance of Overnight Continuous Pulse Oximetry Monitoring: An Exploratory Survey

Abstract

Background: The implementation of tele-health to support the management of COPD patients is increasing. Evaluating patients’ perception, acceptance, and adherence to different tele-health methods may contribute to improve the outcomes of tele-health and its efficacy, in the context that the effectiveness of tele-health in COPD remains inconclusive. We hypothesized that the level of acceptance of continuous overnight monitoring may vary with patient characteristics. Aim: To evaluate patients’ acceptance of continuous overnight home pulse-oximetry monitoring. Methods: A cross-sectional questionnaire study was conducted on COPD patients receiving overnight home pulse-oximetry monitoring as part of a research project at the Royal Free Hospital, London, UK. The questionnaire consisted of 10 questions across four domains: a) willingness to use the monitoring equipment, b) effect on sleep quality, c) convenience of the device, and d) charging preference. Patients’ responses were recorded using a visual analog scale that ranged from 0-10, where the anchor statement at 0 was strongly disagree and 10 was strongly agree. Total acceptability score is presented as mean (SD) as the data were normally distributed. Univariate and multivariate linear regression analyses were applied in order to identify patient characteristics associated with acceptability of use of the home pulse oximeter device. Ethical approvals were obtained from the UK Health Research Authority. Results: 29 participants completed the questionnaire. 72% of participants were compliant with being monitored. Patients had an overall moderate acceptability score with a mean (SD) total score of 59.8 (± 12.6). The use of two multivariate regression models showed no statistically significant associations between patient demographics or their clinical measures and acceptability level. However, univariate linear regression showed that patients who had a higher Charlson comorbidity Index and those living alone had higher acceptability (P = .01, P = .02) respectively. There was no evidence of an association between compliance and patient acceptability of continuous overnight pulse oximeter monitoring (P = .12). Conclusions: There was good acceptance from COPD patients toward the use of home overnight monitoring devices. The majority of patients were willing to be continuously monitored if they thought it would benefit them, including and particularly patients who were living alone and had more comorbidity.