The American Heart Association’s 9th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke reported on a study that showed that a remote monitoring program can improve the condition of heart failure patients who are mobile and may also decrease hospital readmissions.
The study conducted by the Center for Connected Health, a Division of Partners HealthCare, included 150 heart failure patients admitted to Massachusetts General Hospital in Boston. Sixty eight patients averaging age 70 were randomized to receive usual care for heart failure. The remaining 82 patients were offered remote monitoring. Forty two patients accepted the monitoring program but the remaining 40 patients declined to participate.
The goal for the Connected Cardiac Care program was to reduce hospital readmissions, provide timely intervention and help patients understand their condition by using home telemonitoring, said Ambar Kulshreshtha, MD, M.P.H, the lead author of the study and a research fellow at Harvard Medical School and Massachusetts General Hospital. The study was co-authored by Joseph Kvedar, MD, Alice Watson, MD, M.P.H, and Regina Nieves, R.N.
Patients in the remote monitoring group experienced lower average hospital readmission rates (31 readmissions per 100 people) compared to patients in usual care (38 readmissions per 100 people) and non-participants (45 readmissions per 100 people). Patients in the remote monitoring group also had fewer heart failure related readmissions and emergency room visits than usual care and non-participating patients. Researchers said the results show a positive trend but are based on only three months of follow-up and did not reach statistical significance.
Patients received telemonitoring equipment to monitor vital signs such as heart rate, pulse and blood pressure. They also weighed themselves daily and answered a set of questions about symptoms every day. That information was transmitted through the telemonitoring device to a nurse who would call weekly or more often if a patient’s vitals indicated problems, if the patient hadn’t taken their medications, or if the patient wasn’t eating right or exercising.
Post study surveys show:
- 95% believed they were able to manage their heart failure better and an equal number had overall program satisfaction
- All participants said their health improved and they received adequate interactions with a homecare nurse
The researchers said they plan to expand the program to target 350 ambulatory patients by summer of 2008 and are currently developing a method to stratify high risk patients.
