Home health care with telemonitoring improves health status for older adults with heart failure

Abstract

Home telemonitoring can augment home health care services during a patient's transition from hospital to home. Home health care agencies commonly use telemonitors for patients with heart failure although studies have shown mixed results in the use of telemonitors to reduce rehospitalizations. This randomized trial investigated if older patients with heart failure admitted to home health care following a hospitalization would have a reduction in rehospitalizations and improved health status if they received telemonitoring. Patients were followed up to 180 days post-discharge from home health care services. Results showed no difference in the time to rehospitalization or emergency visit between those who received telemonitoring versus usual care. Older heart failure patients who received telemonitoring had better health status by home health care discharge than those who received usual care. Therefore, for older adults with heart failure, telemonitoring may be an important adjunct to home health care services to improve health status.

Figure 1. Screening, Randomization, and Follow-up of the Study Patients

Figure 2. Time to Combined Endpoint

Median Time to CE Control 62 days, TM 60 days, p=.50. Diagonal lines are used to indicate ranges of time at which the survival estimate is indeterminate due to interval censored data. Combined Endpoint: hospitalization or ED visit or urgent care visit or death. HHC = Home Health Care.

Figure 3. Change in the KCCQ: Usual Care vs. Telemonitor

Boxplots show median, IQR, and range of the data up to the “potential outliers” which are individually marked. Means are appended as +. For all domains, mean scores for TM had a larger positive change in KCCQ than mean scores in UC. All p-values < 0.05 except Quality of Life subscale (p=.21).