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Randomized Controlled Trial
. 2010 Sep 1:10:255.
doi: 10.1186/1472-6963-10-255.

A randomized controlled trial of telemonitoring in older adults with multiple chronic conditions: the Tele-ERA study

Paul Y Takahashi  1 , Gregory J Hanson, Jennifer L Pecina, Robert J Stroebel, Rajeev Chaudhry, Nilay D Shah, James M Naessens
Affiliations
Randomized Controlled Trial

A randomized controlled trial of telemonitoring in older adults with multiple chronic conditions: the Tele-ERA study

Paul Y Takahashi et al. BMC Health Serv Res. .

Abstract

Background: Older adults with multiple chronic illnesses are at risk for worsening functional and medical status and hospitalization. Home telemonitoring may help slow this decline. This protocol of a randomized controlled trial was designed to help determine the impact of home telemonitoring on hospitalization. The specific aim of the study reads as follows: to determine the effectiveness of home telemonitoring compared with usual care in reducing the combined outcomes of hospitalization and emergency department visits in an at-risk population 60 years of age or older.

Methods/design: Two-hundred patients with the highest 10% Mayo Clinic Elder Risk Assessment scores will be randomly assigned to one of two interventions. Home telemonitoring involves the use of a computer device, the Intel Health Guide, which records biometric and symptom data from patients in their homes. This information is monitored by midlevel providers associated with a primary care medical practice. Under the usual care scenario, patients make appointments with their providers as problems arise and use ongoing support such as a 24-hour nurse line.Patients will have initial evaluations of gait and quality of life using instruments such as the SF-12 Health Survey, the Kokmen Short Test of Mental Status, and the PHQ-9 health questionnaire. Patients will be followed for 1 year for primary outcomes of hospitalizations and emergency department visits. Secondary analysis will include quality of life, compliance with the device, and attitudes about telemonitoring. Sample size is based on an 80% power to detect a 36% difference between the two groups. The primary analysis will involve Cox proportional time-to-event analysis. Secondary analysis will use t-test comparisons for continuous variables and the chi square test for proportional analysis.

Discussion: Patients randomized to home telemonitoring will have daily assessments of their health status using the device. Registered nurse monitoring will assess any change in status followed by videoconferencing by a mid-level provider. We obtained trial registration and Institutional Review Board approval.

Trial registration: Trial registration number through http://www.clinicaltrials.gov: NCT01056640.

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References

    1. Berk ML, Monheit AC. The concentration of health care expenditures, revisited. Health affairs (Project Hope) 2001;20(2):9–18. doi: 10.1377/hlthaff.20.2.9. - DOI - PubMed
    1. Pare G, Jaana M, Sicotte C. Systematic review of home telemonitoring for chronic diseases: the evidence base. J Am Med Inform Assoc. 2007;14(3):269–277. doi: 10.1197/jamia.M2270. - DOI - PMC - PubMed
    1. Tran K. Canadian Agency for Drugs and Technologies in Health: Home Telehealth for Chronic Disease Management Technology Report. HTA. 2008.
    1. Projected Population of the United States, by Age and Sex: 2000 to 2050
    1. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–613. doi: 10.1046/j.1525-1497.2001.016009606.x. - DOI - PMC - PubMed

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