Abstract
Patients with heart failure (HF) are at risk for readmissions, either due to progression or related co-morbidities. Post-discharge telemonitoring (TM) provides support to HF patients during the critical hospital to home transition. Here, we provide a safety-net hospital's experience with HF telemonitoring(TM)
We conducted a retrospective chart review of admissions between November 2015 and December 2016 for 205 patients who were provided with TM kits at discharge. TM was achieved through internet-based weight, blood pressure, and symptoms monitoring. Pre-discharge HF education by the nurse practitioners (NPs) included instructions on the use of the telehealth kits. Abnormal values triggered a telephone call to the patients by the NPs. Data on demographics, health insurance, medications and TM usage were collected. Primary endpoints were 30-day all-cause and HF-related readmissions. Chi-square tests was used to compare all-cause and HF-related 30-day readmission rates for the TM group vs. the non-TM group and Fisher's exact test for 30-day readmission rates for participants with >= 50% TM usage compared to those with < 50% usage.
The mean age was 58 years, 43.4% were female, 51% had Medicaid or were self-pay, 61% had systolic HF and 87% were compliant with TM (>=50% use). 30-day readmission rates were calculated for all patients admitted for HF during the study duration, irrespective of their TM assignment, (n=1242). There was a statistically significant reduction in all-cause 30-day readmission rate in the TM group compared to the non-TM group (12.2% vs. 20.5%, p=0.0055) but no significant difference in 30-day HF-related readmission rates (9.3% vs. 12.8%, p=0.1563). TM compliance was associated with a reduction in all-cause readmission rates for those with >= 50% compliance compared to those with <50% compliance (8.4% vs 38.5%, p=0.0002) as well as 30- HF-related readmission rates (5.6% vs 34.6%, p<0.0001).
In our unique patient population, TM reduced all-cause 30-day readmission in patients hospitalized for HF. When TM was optimally utilized (>=50%), there was a reduction in both all-cause and HF-related 30-day readmission rates. Figure 1, Figure 2