Effectiveness of telemonitoring-enhanced support over structured telephone support in reducing heart failure-related healthcare utilization in a multi-ethnic Asian setting.
J Telemed Telecare
; 26(6): 332-340, 2020 Jul.
Article
in En
| MEDLINE
| ID: mdl-30782070
ABSTRACT
AIMS:
Our study aimed to compare the effectiveness of telemonitoring over structured telephone support in reducing heart failure-related healthcare utilization.METHODS:
This was a non-randomised controlled study comparing 150 recently discharged heart failure patients enrolled into telemonitoring and 55 patients who only received structured telephone support after rejecting telemonitoring. Patient activation, knowledge and self-management levels were measured at baseline and the one year upon programme completion using the Patient Activation Measure, the Dutch Heart Failure Knowledge Scale and the Self-Care of Heart Failure Index respectively. Differences in heart failure-related and all-cause hospitalization rates, total bed days and mortality rates at 180 days and at one year, knowledge and self-management scores and total cost of care between groups at one year were analysed.RESULTS:
Average age of telemonitoring was 57.9 years and 63.9 years for structured telephone support. Significant difference in adjusted 180-day all-cause bed days (telemonitoring five days versus structured telephone support 9.8 days), heart failure-related bed days (telemonitoring 1.2 days versus structured telephone support six days) and adjusted one-year heart failure-related bed days (telemonitoring 2.2 days versus structured telephone support 6.6 days) were observed. Telemonitoring was associated with reduced all-cause one-year mortality (hazard ratio 0.32, p = 0.02). Estimated mean maintenance and confidence scores were significantly higher in the telemonitoring group at one year. No differences in all-cause and HF-related readmission rates and knowledge levels were observed. The one-year total cost of care was predicted to be Singapore dollars (SG$) 2774.4 lower (p = 0.07) in telemonitoring.CONCLUSION:
In conclusion, telemonitoring was associated with lower all-cause and heart failure-related total bed days at 180 days, lower heart failure-related total bed days and total cost of care at one year as compared with structured telephone support.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Telephone
/
Monitoring, Ambulatory
/
Remote Consultation
/
Heart Failure
Type of study:
Clinical_trials
/
Evaluation_studies
/
Prognostic_studies
Aspects:
Implementation_research
Limits:
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Asia
Language:
En
Journal:
J Telemed Telecare
Journal subject:
INFORMATICA MEDICA
/
SERVICOS DE SAUDE
Year:
2020
Document type:
Article
Affiliation country:
Singapore