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Of the coolest (or creepiest, depending on how you look at it) health care innovations currently in use, the toilet that keeps track of how often you pee probably tops the list. Systems like this, designed for monitoring health from afar, are lauded as the high-tech assisted-living solution for the aging population. They're promoted as a way of allowing people with chronic conditions to live on their own, all the while remaining under the watchful eye of health professionals who can identify symptoms that indicate changes or declines in their health.
As implemented by the U.K. Department of Health, patient homes are equipped with monitors that keep track of their vital signs -- which are collected by equipment like blood pressure cuffs, scales, and blood glucometers -- and then transmit that information to remotely located clinicians.
But the systems have been rolled out based largely on assumptions of their utility instead of evidence for their effectiveness, and a study published by BMJ is now suggesting that remote monitoring may not have any quality of life or psychological benefit for people managing chronic conditions.
Following 1,500 patients as they used telehealth to manage conditions like chronic obstructive pulmonary disease, diabetes, and heart failure over the course of a year, British researchers found no evidence of improvements in the patients' health-related quality of life, nor of their symptoms of anxiety or depression, as compared to patients receiving ordinary, low-tech care. They based their measures on a series of questionnaires administered before the system was installed and at various points during the year that it was used.
The authors take a swipe at previous reviews that suggest differently, arguing that, "while most conclude that telehealth is beneficial, such inferences are not supported by the evidence they present."
On the upside, they didn't find any negative effects -- which is significant in that many have expressed concern that being constantly monitored might increase people's anxiety. And this study didn't look at objective health or cost efficiency. The larger trial from which this study emerges, which includes a variation on remote health monitoring intended for vulnerable populations such as people with dementia or physical disabilities, previously identified an astounding 45 percent decline in mortality, for example, and a 95 percent reduction in costs for treating infertility. But quality of life, depression, and anxiety are all linked to worse outcomes for patients with chronic conditions, the authors argue, so from a patient's perspective, it may not be the optimal solution.