Impact of Telehealth on Clinical Outcomes in Patients With Heart Failure

The purpose of this randomized field study was to determine the effects of telehomecare on hospitalization, emergency department (ED) use, mortality, and symptoms related to sodium and fluid intake, medication use, and physical activity. The sample consists of 284 patients with heart failure. The authors used logistic regression to study the effects of telehomecare on health services utilization and mortality and a general linear model to analyze changes in self-reported symptoms. On average, patients in the telehomecare groups had a lower probability of hospitalizations and ED visits than did patients in the control group. Differences were statistically significant at 60 days but not 120 days. Results show a greater reduction in symptoms for patients using telehomecare compared to control patients. The technology enables frequent monitoring of clinical indices and permits the home health care nurse to detect changes in cardiac status and intervene when necessary.

[1]  K. Furie,et al.  Heart disease and stroke statistics--2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. , 2008, Circulation.

[2]  A. Jerant,et al.  Reducing the Cost of Frequent Hospital Admissions for Congestive Heart Failure: A Randomized Trial of a Home Telecare Intervention , 2001, Medical care.

[3]  Jacob Cohen Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[4]  Teaching Self-Management of Diabetes Via Telehomecare , 2002, Home healthcare nurse.

[5]  B. Avitall,et al.  Outcomes of chronic heart failure. , 2003, Archives of internal medicine.

[6]  G. Guyatt,et al.  Measurement of health status. Ascertaining the minimal clinically important difference. , 1989, Controlled clinical trials.

[7]  Peter Woodbridge,et al.  Outcomes associated with a home care telehealth intervention. , 2006, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[8]  K. Furie,et al.  Heart disease and stroke statistics--2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. , 2007, Circulation.

[9]  S. Silver,et al.  Heart Failure , 1937, The New England journal of medicine.

[10]  B. Tabachnick,et al.  Using Multivariate Statistics , 1983 .

[11]  B. Johnston,et al.  Outcomes of the Kaiser Permanente Tele-Home Health Research Project. , 2000, Archives of family medicine.

[12]  M. Shaul What You Should Know Before Embarking on Telehome Health: Lessons Learned From a Pilot Study , 2000, Home healthcare nurse.

[13]  G Harris Kaiser Permanente Tele-Home Health Research Project. , 2000, Telemedicine today.

[14]  Kathryn H. Bowles,et al.  Applying Research Evidence to Optimize Telehomecare , 2007, The Journal of cardiovascular nursing.

[15]  D. Mancini,et al.  Use of telemonitoring to decrease the rate of hospitalization in patients with severe congestive heart failure. , 1999, The American journal of cardiology.

[16]  K. Martin,et al.  Home health clients: characteristics, outcomes of care, and nursing interventions. , 1993, American journal of public health.

[17]  Huong Q. Nguyen,et al.  Supporting Cardiac Recovery Through eHealth Technology , 2004, The Journal of cardiovascular nursing.

[18]  Gerard Castro,et al.  The Effect of Physiologic Home Monitoring and Telemanagement on Chronic Heart Failure Outcomes , 1999 .