PHOTO | Revolutionary patient monitoring: A phone app helps treat one of the most dangerous diseases

Photo: Profimedia

Researchers from University College London (UCL) and the Royal Free Hospital in London they started testing smartphone app developed to enable follow-up of patients with liver disease after discharge from hospital, published "UCL News" (UCL News). This system, called CirrhoCare, is intended to improve the monitoring of the condition of cirrhosis of the liver in people who have been in the hospital and have 37 percent risk to finish in again hospital bed within a month.

A 2020 pilot study involving 20 patients and 20 controls showed that the app reduced readmission to hospital by 38 percent after 10 weeks, but also improved the use of resources in the hospital itself.

The new trial will follow more than 200 patients.

- At the moment, the follow-up of patients with cirrhosis of the liver who have been discharged from the hospital is limited. It comes down to scheduled meetings every few weeks. It turns out that people need admission only when it is too late - said Professor Raj Mukherjee from the Faculty of Medicine at UKL.

– This innovative approach in which we use CirrhoCare determines the signs of early liver failure so that patients can receive the necessary help immediately. The goal is to prevent frequent hospitalizations, but also to improve the detection of those who urgently need help. The number of deaths due to liver disease has quadrupled since 1970 and continues to rise, he explained.


Patients who participate in the test will receive smartphone with SIM card and CirrhoCare app, as well as a smart watch which will enable monitoring of pulse, pressure and temperature and a personal scale that will measure weight, but also fluids in the body.

These devices, to which the doctors will have access, will also record it patients' sleep, as well as theirs physical activity, and patients will occasionally have to answer questions in the application about how they feel and how much fluid they have drunk. The data is analyzed by algorithms that determine if there are any complications.

– I discovered that I have a fatty liver during a routine blood donation. I felt fine, but my condition quickly worsened, so I got involved in research. It was very helpful for me, I felt like someone was following me 24 hours a day. There were several calls because my blood pressure was so low that they were concerned. The app made me get enough sleep, which I thought I wasn't getting. I also watched what I ate more. "Honestly, I felt good using it and I was sorry when I had to return it," said Pamela Everett, 71, from Holborn, who has cirrhosis of the liver.

A month ago, the Mukherjee-led team also presented the idea that smartphone cameras could use photographs of the forehead, whites of the eyes and lower eyelids in order to assess the level of bilirubin in the blood and thus to monitor the condition of patients with cirrhosis of the liver.

– One of the reasons liver disease is so challenging is that patients' conditions can deteriorate very quickly. The unfortunate fact is that when patients arrive at the clinic with a higher degree of jaundice than expected, there is a good chance that the disease is very advanced. The approach we evaluated in this study allowed us to follow patients in their homes much more frequently than is currently possible. We hope that it will help in detecting deterioration of clinical symptoms before the condition becomes critical - said Professor Raj Mukherjee at the time.

As eKlinika wrote, cirrhosis of the liver is a chronic pathological condition in which healthy liver tissue is replaced by (fibrous) scar tissue. Any scar tissue is dysfunctional, including that which forms in the liver, which causes the normal functioning of the liver to be impaired. The more scars there are, and the less healthy tissue remains, the more severe the cirrhosis of the liver. Liver cirrhosis is an incurable disease, and advanced liver cirrhosis is life-threatening.


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