Impact of Telemonitoring on Health Status

Circ Cardiovasc Qual Outcomes. 2017 Dec;10(12):e004148. doi: 10.1161/CIRCOUTCOMES.117.004148.

Abstract

Background: Although noninvasive telemonitoring in patients with heart failure does not reduce mortality or hospitalizations, less is known about its effect on health status. This study reports the results of a randomized clinical trial of telemonitoring on health status in patients with heart failure.

Methods and results: Among 1521 patients with recent heart failure hospitalization randomized in the Tele-HF trial (Telemonitoring to Improve Heart Failure Outcomes), 756 received telephonic monitoring and 765 usual care. Disease-specific health status was measured with the Kansas City Cardiomyopathy Questionnaire (KCCQ) within 2 weeks of discharge and at 3 and 6 months. Repeated measures linear regression models were used to assess differences in KCCQ scores between patients assigned to telemonitoring and usual care over 6 months. The baseline characteristics of the 2 treatment arms were similar (mean age, 61 years; 43% female and 39% black). Over the 6-month follow-up period, there was a statistically significant, but clinically small, difference between the 2 groups in their KCCQ overall summary and subscale scores. The average KCCQ overall summary score for those receiving telemonitoring was 2.5 points (95% confidence interval, 0.38-4.67; P=0.02) higher than usual care, driven primarily by improvements in symptoms (3.5 points; 95% confidence interval, 1.18-5.82; P=0.003) and social function (3.1 points; 95% confidence interval, 0.30-6.00; P=0.03).

Conclusions: Telemonitoring results in statistically significant, but clinically small, improvements in health status when compared with usual care. Given that the KCCQ was a secondary outcome, the benefits should be confirmed in future studies.

Clinical trial registration: URL: https://www.clinicaltrials.gov/. Unique identifier: NCT00303212.

Keywords: disease management; health status; heart failure; hospitalization.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Chi-Square Distribution
  • Female
  • Health Status*
  • Heart Failure / diagnosis
  • Heart Failure / physiopathology
  • Heart Failure / psychology
  • Heart Failure / therapy*
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Recovery of Function
  • Self Care*
  • Social Behavior
  • Surveys and Questionnaires
  • Telemedicine / methods*
  • Telephone
  • Time Factors
  • Treatment Outcome
  • United States

Associated data

  • ClinicalTrials.gov/NCT00303212