Real-time pump telemetry: An innovative approach to monitoring adherence in home parenteral nutrition

Adherence to home parenteral nutrition (HPN) is rarely quantified by direct monitoring. Leveraging device-recorded, time-stamped telemetry from connected infusion pumps, we evaluated three clinically relevant dimensions of adherence: daily volume delivered, weekly total volume received, and weekly session execution. We analyzed 51 patients. The average number of monitoring days per patient was 48.98 ± 46.34. The prescribed daily volume was 1369.6 ± 463.1 mL. Patient-level means were: daily volume adherence, 92.0 ± 11.7 %; weekly total volume adherence, 70.4 ± 22.7 %; and weekly session adherence, 72.4 ± 25.3 %. Overall, 59.2 % of patients fell below the 80 % threshold for weekly total volume adherence. These findings highlight a clinically meaningful discrepancy: missed sessions, rather than per-infusion inaccuracies, account for the majority of under-delivery in HPN. This underscores the potential utility of real-time telemetry as a tool for identifying and addressing adherence gaps in clinical practice.