A Large Cohort Study Evaluating Adherence to Negative Pressure Wound Therapy with a Remote Therapy Monitoring Program

Background: A remote therapy monitoring (RTM) system has been developed for use with a negative pressure wound therapy (NPWT) unit for patients in the homecare setting. In conjunction with RTM, a network of virtual therapy specialists called patients when their therapy usage was low and provided education to assist with therapy adherence.

Purpose: The objective of this evaluation was to characterize and quantify the interactions made by the RTM network and to examine the relationship between RTM and patient adherence.

Methods: Our evaluation included 4450 patients that were prescribed NPWT with RTM between December 2016 and October 2018. For these patients, 25,621 interactions were made which included calls (96.3%) and emails (3.7%) that were both outbound (90%) and inbound (10%).

Results: Among the patients, 96.5% received a welcome call, 83.1% received at least one call due to low adherence, and 31.8% had an escalation call made to their treating clinician. Of the 3,698 patients with at least one low adherence call, 97.0% were successfully reached through direct interaction or voicemail, with an average of 2.5 successful adherence calls per patient. The mean number of adherence calls increased as the length of therapy increased.  Mean therapy usage on the day triggering an adherence call was 9.5 hours. The day after the adherence call, therapy increased in 84.1% of the instances, with a mean increase of 9.4 hours. Throughout therapy, NPWT was used 84.2% of the time with an average of 20.2 hours/day.

Conclusions: This evaluation suggests there is an ability to influence patient adherence through active engagement, potentially improving outcomes and reducing wound costs.