AHA Quality: Remote Monitoring May Improve Heart Failure Outcomes
By Charles Bankhead
BALTIMORE, 05 may 2008 -- When heart failure patients do a daily home self-assessment of vital signs that is automatically sent by phone to physicians, the likelihood of hospital readmissions and emergency room visits tends to be reduced, a preliminary study suggested.
Patients who provided such daily information about their health status had nonsignificant trends toward a lower readmission rate and fewer ER visits compared with those given usual management, Ambar Kulshreshtha, M.D., of Harvard, reported at the American Heart Association meeting here on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.
Although the between-group differences did not reach statistical significance, they suggest that telemonitoring has the potential to improve heart failure outcomes.
"Patients could see the fluctuation in their vitals and realize they hadn't taken their medications or weren't eating right or exercising," said Dr. Kulshreshtha. "A weekly call from the nurse reinforces lifestyle management of the patient's heart failure."
The study evolved from previous research showing that remote monitoring improved outcomes in homebound patients with heart failure. Dr. Kulshreshtha and colleagues hypothesized that daily telemonitoring would encourage behavior change and intervention that would improve outcomes in ambulatory patients, as well.
The study involved 150 heart failure patients, 68 of them randomized to usual care (mean age 70) and 82 to remote telemonitoring. Forty of the 82 patients declined to participate (mean age 68), leaving 42 participants (mean age 65) in the monitoring group.
Using special telemonitoring equipment, patients in the remote monitoring arm assessed vital signs and weighed themselves daily. The information was transmitted to a nurse who coordinated care with a physician. The nurse also called each patient weekly or more often if any vital signs were abnormal.
The primary aim of the study was to compare hospital readmissions and ER visits between patients who participated in remote monitoring and those who were assigned to usual care or who declined remote monitoring.
After three months of follow-up, the remote monitoring group had a hospital readmission rate of 0.31 (31 per 100 patients) compared with 0.38 for the usual care group and 0.45 for the nonparticipants. The usual-care group and nonparticipants also had more ER visits compared with the remotely monitored patients. None of the differences was statistically significant.
Results of a post-study survey showed that 95% of remotely monitored patients said the program improved their heart failure and helped them avoid hospitalization. Additionally, 95% said the program helped them manage their condition better and expressed overall satisfaction with the program. Telemonitoring participants also said the equipment was easy to use.
Dr. Kulshreshtha and colleagues reported no disclosures.
Primary source: AHA Quality MeetingSource reference:Kulshreshtha A, et al "Using information technology to improve outcomes in patients with heart failure: The value of remote monitoring" AHA Quality Meeting 2008; Abstract 21.
By Charles Bankhead
BALTIMORE, 05 may 2008 -- When heart failure patients do a daily home self-assessment of vital signs that is automatically sent by phone to physicians, the likelihood of hospital readmissions and emergency room visits tends to be reduced, a preliminary study suggested.
Patients who provided such daily information about their health status had nonsignificant trends toward a lower readmission rate and fewer ER visits compared with those given usual management, Ambar Kulshreshtha, M.D., of Harvard, reported at the American Heart Association meeting here on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.
Although the between-group differences did not reach statistical significance, they suggest that telemonitoring has the potential to improve heart failure outcomes.
"Patients could see the fluctuation in their vitals and realize they hadn't taken their medications or weren't eating right or exercising," said Dr. Kulshreshtha. "A weekly call from the nurse reinforces lifestyle management of the patient's heart failure."
The study evolved from previous research showing that remote monitoring improved outcomes in homebound patients with heart failure. Dr. Kulshreshtha and colleagues hypothesized that daily telemonitoring would encourage behavior change and intervention that would improve outcomes in ambulatory patients, as well.
The study involved 150 heart failure patients, 68 of them randomized to usual care (mean age 70) and 82 to remote telemonitoring. Forty of the 82 patients declined to participate (mean age 68), leaving 42 participants (mean age 65) in the monitoring group.
Using special telemonitoring equipment, patients in the remote monitoring arm assessed vital signs and weighed themselves daily. The information was transmitted to a nurse who coordinated care with a physician. The nurse also called each patient weekly or more often if any vital signs were abnormal.
The primary aim of the study was to compare hospital readmissions and ER visits between patients who participated in remote monitoring and those who were assigned to usual care or who declined remote monitoring.
After three months of follow-up, the remote monitoring group had a hospital readmission rate of 0.31 (31 per 100 patients) compared with 0.38 for the usual care group and 0.45 for the nonparticipants. The usual-care group and nonparticipants also had more ER visits compared with the remotely monitored patients. None of the differences was statistically significant.
Results of a post-study survey showed that 95% of remotely monitored patients said the program improved their heart failure and helped them avoid hospitalization. Additionally, 95% said the program helped them manage their condition better and expressed overall satisfaction with the program. Telemonitoring participants also said the equipment was easy to use.
Dr. Kulshreshtha and colleagues reported no disclosures.
Primary source: AHA Quality MeetingSource reference:Kulshreshtha A, et al "Using information technology to improve outcomes in patients with heart failure: The value of remote monitoring" AHA Quality Meeting 2008; Abstract 21.
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