Laura Leyva Casillas, MBA, MSBA
Tamara Stanton, BSN, RN
April Lumpkins, BSN, RN, CWOCN, CFCN
Therapy nonadherence can preempt the effectiveness of modalities, such as negative pressure wound therapy (NPWT), and may result in adverse or costly outcomes.1,2 Annually, an estimated $100 to $300 billion of avoidable United States healthcare costs may be attributed to nonadherence.3 Outpatient NPWT* complemented by a remote therapy monitoring (RTM†) program serves as a digital solution to track therapy adherence.2,4 The RTM program is staffed by a network‡ of virtual therapy specialists (VTS), who contact patients and address barriers to low NPWT adherence. Several outpatient studies have evaluated the impact of RTM-equipped NPWT on adherence and cost savings.2,4,5 Patient attitudes concerning RTM-equipped NPWT as an acceptable intervention to improve adherence warrants investigation. The objective of this study is to evaluate patient outlook on RTM services and VTS interactions to influence adherence to NPWT. The study identified 8644 patients, who received RTM-equipped NPWT from May 2017 to April 2019. Seventy-seven percent (6616/8644 patients) were contacted to complete a 3-question qualitative exit survey after therapy was discontinued. There was a 48% (3159/6616) response rate among patients that were contacted. Responses captured feedback concerning RTM satisfaction, VTS influence on user-engagement, and receptiveness to RTM-equipped NPWT for subsequent wound care needs. When asked about the RTM services, 94% (2977/3159) of respondents expressed satisfaction compared to 5% (156/3159) neutral and 1% (26/3159) unsatisfied. Concerning perceptions of RTM services to influence increased usage, 87% (2,745/3159) responded affirmatively compared to 5% (162/3159) in the negative and 8% (252/3159) neutral/non-responsive. Ninety-one percent (2873/3159) of respondents expressed a willingness to receive RTM-equipped NPWT for future wound care versus 2% (69/3159) opposed and 7% (217/3159) neutral/non-responsive. Our analysis of exit survey responses suggests that NPWT outpatients generally possess a favorable attitude toward RTM services and VTS support, which may influence consistent device usage.
*ACTIV.A.C.™ Therapy System, †iOn PROGRESS™ Remote Therapy Monitoring, ‡iOn PROGRESS™ Care Network (KCI, an ACELITY Company, San Antonio, TX)
1. Reach G. Patient education, nudge, and manipulation: defining the ethical conditions of the person-centered model of care. Patient Prefer Adherence. 2016 Apr 4;10:459-68.
2. Griffin L and Casillas L. Evaluating the impact of a patient-centered remote monitoring program on adherence to negative pressure wound therapy. Wounds. 2018 Mar;30(3):E29-E31.
3. Iuga AO, McGuire MJ. Adherence and health care costs. Risk Manag Healthc Policy. 2014 Feb 20;7:35-44.
4. Griffin L and Casillas L. A patient-centered Remote therapy monitoring program focusing on increase adherence to wound therapy: a large cohort study. Wounds. 2018 Aug;30(8):E81-E83.
5. Griffin L and Sifuentes MM. Retrospective Payor Claims Analysis of Patients Receiving Outpatient Negative Pressure Wound Therapy with Remote Therapy Monitoring. Wounds. 2019 Feb;31(2):E9-E11.