Feasibility, Adherence, Acceptance and Usability of a Multimodal Telemonitoring for Pediatric Post-COVID Syndrome: A Bicentric Pilot Study

Clinical Snapshot

Key Findings

• P Value: Not reported - descriptive feasibility study

• Effect Size: High adherence: 3.4-4.6 digital measurements per week

• Primary Outcome: High feasibility demonstrated with 86% questionnaire completion and 97% video consultation attendance

• Nnt Or Sensitivity: System Usability Scale scores: 81.25/100 (patients), 75.42/100 (parents) indicating excellent usability

• Confidence Interval: Not reported in abstract

Clinical Application

High feasibility demonstrated but requires technical infrastructure and clinical support systems Relevant to Australian telehealth initiatives, particularly for rural/remote access. Would need integration with My Health Record and PBS telehealth item numbers. RACGP telehealth guidelines support such approaches for chronic condition management Adolescents with Post-COVID Syndrome in specialist care settings with access to digital technology

Abstract

Existing healthcare infrastructure struggles to meet the complex care required for pediatric Post-COVID Syndrome (pPCS). Telemonitoring offers potential to enhance care access, reduce patient burden, and ensure continuity. This study introduces and evaluates a novel, multimodal telemonitoring concept for pPCS with high translational potential for broader pediatric chronic and post-infectious conditions. Telemonitoring included a patient app, digital sensors (spirometer, smartwatch), Patient Reported Outcome Measures, chat/video consultations (VC), and a medical telemonitoring platform. Patients aged 12-17 years with diagnosed PCS were recruited from two pPCS outpatient university clinics in Bielefeld and Munich, Germany. Monitoring lasted three months. Evaluation focused on feasibility, adherence, acceptance, and usability, using monitoring data, the System Usability Scale (SUS), Technology Usage Inventory (TUI), and a custom survey completed by patients and parents. 30 patients (mean age: 15y ± 1.9; 57% female (17/30); mean Baseline Bell-Score: 36.4) and 30 parents participated. Adherence was high, with an average of 3.4 (smartwatch) to 4.6 (spirometry) measurements/week. Questionnaire response rate was 86% (411/480) and 97% (58/60) of VCs were conducted. SUS scores indicated very high usability (patients: 81.25/100; parents: 75.42/100). TUI results showed low skepticism, and high interest. Telemonitoring supported symptom management independent of in-person visits, despite sensor connectivity issues. This is the first study to demonstrate successful integration of telemonitoring in pPCS, with high adherence and positive feedback from all stakeholders supporting its potential. Despite occasional technical challenges and resource needs, this concept shows promise for broader hybrid telemonitoring care implementation in PCS and other post-infectious syndromes. TRIAL REGISTRATION: German Clinical Trials Register (DRKS), trial registration number: DRKS00029354. Registered 07 February 2023 - Retrospectively registered https://drks.de/search/en/trial/DRKS00029354/entails.

References

1. 1.Oftring, Z. S., Schmidt, J., Greenfield, J., Hägele, M., Farzaneh, A., Hamelmann, E., Behrends, U., & Kuhn, S. (2026). Feasibility, Adherence, Acceptance and Usability of a Multimodal Telemonitoring for Pediatric Post-COVID Syndrome: A Bicentric Pilot Study. Journal of Medical Systems. https://doi.org/10.2196/65220