TYTOCARE™ home telemonitoring device after radical cystectomy to optimise postoperative outcomes

BJU Int. 2024 Dec 26. doi: 10.1111/bju.16637. Online ahead of print.

Abstract

Objectives: To evaluate the role of the TYTOCARE™ telemedicine programme for home telemonitoring during the early postoperative period following radical cystectomy (RC) in a prospective single-centre study.

Materials and methods: The study included patients aged <80 years with internet access who underwent RC at our institution between March 2021 and August 2023. Upon discharge, patients were monitored at home using the TYTOCARE™ telemedicine system. Daily, patients completed a symptom questionnaire and recorded heart rate, body temperature, intestinal sounds, and urine output, and wound/ostomy evaluations via photos. Weekly televisits via the TYTOCARETM platform and app were scheduled, with additional controls as needed. After 30 days, patients assessed their satisfaction using a visual analogue scale (VAS; 0-100) and a Telemedicine Satisfaction Questionnaire (TSQ; 1-5) and any technical issues were documented. A control group of patients, who underwent RC in the same study period but who did not take part in a postoperative telemonitoring programme, was chosen for comparison, with analysis of demographics, peri-operative data, postoperative complications and hospital readmissions within 30 days after discharge.

Results: A total of 16 patients were included in the TYTOCARETM group, and 88 in the control group. The mean VAS satisfaction scores were 86.4 (patients) and 92.3 (healthcare providers). The mean TSQ score was 4.3, indicating high satisfaction. All TYTOCARETM patients reported they would use and recommend the device. Two patients encountered minor technical issues, which were easily resolved. The TYTOCARETM group had a shorter hospital stay (11 vs 14 days; P = 0.04) and fewer medical complications ( 2/16 vs 21/88; P = 0.02). No TYTOCARETM patients were readmitted within 30 days, compared to 20.4% in the control group.

Conclusion: The TYTOCARETM telemonitoring programme seems to be feasible and highly adhered to by patients and caregivers, with reductions in length of hospital stay, medical complications and hospital readmissions within the first 30 days post-discharge.

Keywords: bladder cancer; complications; monitoring; rehabilitation; surgical recovery; telemedicine.