Adherence among telemonitored patients with heart failure to pharmacological and nonpharmacological recommendations

Abstract

In many healthcare systems, the outcomes of care for patients with heart failure (HF) are in need of improvement. By applying telemonitoring, this study aimed to assess its short-term impact on patients' disease-specific knowledge, adherence, and depression. As part of a larger trial (N = 1,023, 17 centers), this study reports preliminary findings among 101 patients from three Dutch hospitals. Patients were randomized to receive care using telemonitoring or standard care. Data concerning patients' disease-specific knowledge, adherence to pharmacological and nonpharmacological recommendations, and depression were collected by postal questionnaires. In this study, data collected before randomization and 3 months afterwards were analyzed. Disease-specific knowledge improved significantly in two of the three hospitals (p < 0.001 and p = 0.040). Adherence in terms of fluid restrictions (p = 0.012), daily weighing (p < 0.001), physical exercising (p = 0.034), and alcohol restrictions (p = 0.040) improved significantly in the telemonitoring group. Additionally, in contrast with the hypothesized increase of depression, the use of telemonitoring resulted in a substantial but statistically not significant decrease in depression. The improved adherence rates within the 3-month study period underscore the potential of telemonitoring to enhance self-management among HF patients and consequently its potential impact on other outcomes. Longer-term results will enable solid conclusions to be reached concerning the relation between telemonitoring and patients' adherence.