Heart failure (HF) is the leading cause of rehospitalization in older adults. The purpose of this pilot study was to examine whether telemonitoring by an advanced practice nurse reduced subsequent hospital readmissions, emergency department visits, costs, and risk of hospital readmission for patients with HF. One hundred two patient/caregiver dyads were randomized into 2 groups postdischarge; 84 dyads completed the study. Hospital readmissions, emergency department visits, costs, and days to readmission were abstracted from medical records. Participants were interviewed soon after discharge and 3 months later about effects of telemonitoring on depressive symptoms, quality of life, and caregiver mastery. There were no significant differences due to telemonitoring for any outcomes. Caregiver mastery, informal social support, and electronic home monitoring were not significant predictors for risk of hospital readmission. Further studies should address the interaction between the advanced practice nurse and follow-up intervention with telemonitoring of patients with HF to better target those who are most likely to benefit.
"M-H Overall (I-squared = 18.4%, p = 0.268) Laramee et al, 2003 Riegel et al, 2002 Dunagan et al, 2005 Schwarz et al, 2008 Blue et al, 2001 Riegel et al, 2006 Woodend et al, 2008 study GESICA Investigators et al, 2005 DeBusk et al, 2004 Sisk et al, 2006 D+L Overall Cleland et al, 2005 0.93 (0. "
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to assess the effect of remote patient monitoring (RPM) on the outcome of chronic heart failure (HF) patients.
RPM via regularly scheduled structured telephone contact between patients and health care providers or electronic transfer of physiological data using remote access technology via remote external, wearable, or implantable electronic devices is a growing modality to manage patients with chronic HF.
After a review of the literature published between January 2000 and October 2008 on a multidisciplinary heart failure approach by either usual care (in-person visit) or RPM, 96 full-text articles were retrieved: 20 articles reporting randomized controlled trials (RCTs) and 12 reporting cohort studies qualified for a meta-analysis.
Respectively, 6,258 patients and 2,354 patients were included in RCTs and cohort studies. Median follow-up duration was 6 months for RCTs and 12 months for cohort studies. Both RCTs and cohort studies showed that RPM was associated with a significantly lower number of deaths (RCTs: relative risk [RR]: 0.83, 95% confidence interval [CI]: 0.73 to 0.95, p = 0.006; cohort studies: RR: 0.53, 95% CI: 0.29 to 0.96, p < 0.001) and hospitalizations (RCTs: RR: 0.93, 95% CI: 0.87 to 0.99, p = 0.030; cohort studies: RR: 0.52, 95% CI: 0.28 to 0.96, p < 0.001). The decrease in events was greater in cohort studies than in RCTs.
RPM confers a significant protective clinical effect in patients with chronic HF compared with usual care.
Journal of the American College of Cardiology 10/2009; 54(18):1683-94. DOI:10.1016/j.jacc.2009.08.017 · 16.50 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.