The Effect of Noninvasive Telemonitoring for Chronic Heart Failure on Health Care Utilization: Systematic Review

Auener, Stefan L; Remers, Toine E. P.; Dulmen, Simone A. van; Westert, Gert P; Kool, Rudolf B; Jeurissen, Patrick

doi:10.2196/26744

Cited by 22 publications

(25 citation statements)

References 58 publications

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“…Remote monitoring as a feature of eHealth interventions may include parameters for detecting symptom and illness deterioration, successfully reducing readmissions among patients with HF [ 19 - 21 ]. However, in our study, the effects on readmissions from remote monitoring were inconclusive.…”

Section: Discussionmentioning

confidence: 99%

“…Several recent reviews have summarized the findings from eHealth follow-up interventions for patients with HF and provided information about the efficiency of such interventions. Auener et al [ 19 ] investigated the effects of telemonitoring programs on different aspects of health care use from 16 randomized controlled trials (RCTs) and 13 nonrandomized studies. All studies included weight as a parameter, whereas only 4 included electrocardiography measures as a physiological parameter.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Posthospitalization Follow-Up of Patients With Heart Failure Using eHealth Solutions: Restricted Systematic Review

Husebø¹,

Storm²,

Urstad³

et al. 2022

J Med Internet Res

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Background Heart failure (HF) is a clinical syndrome with high incidence rates, a substantial symptom and treatment burden, and a significant risk of readmission within 30 days after hospitalization. The COVID-19 pandemic has revealed the significance of using eHealth interventions to follow up on the care needs of patients with HF to support self-care, increase quality of life (QoL), and reduce readmission rates during the transition between hospital and home. Objective The aims of this review are to summarize research on the content and delivery modes of HF posthospitalization eHealth interventions, explore patient adherence to the interventions, and examine the effects on the patient outcomes of self-care, QoL, and readmissions. Methods A restricted systematic review study design was used. Literature searches and reviews followed the (PRISMA-S) Preferred Reporting Items for Systematic Reviews and Meta-Analyses literature search extension checklist, and the CINAHL, MEDLINE, Embase, and Cochrane Library databases were searched for studies published between 2015 and 2020. The review process involved 3 groups of researchers working in pairs. The Mixed Methods Appraisal Tool was used to assess the included studies’ methodological quality. A thematic analysis method was used to analyze data extracted from the studies. Results A total of 18 studies were examined in this review. The studies were published between 2015 and 2019, with 56% (10/18) of them published in the United States. Of the 18 studies, 16 (89%) were randomized controlled trials, and 14 (78%) recruited patients upon hospital discharge to eHealth interventions lasting from 14 days to 12 months. The studies involved structured telephone calls, interactive voice response, and telemonitoring and included elements of patient education, counseling, social and emotional support, and self-monitoring of symptoms and vital signs. Of the 18 studies, 11 (61%) provided information on patient adherence, and the adherence levels were 72%-99%. When used for posthospitalization follow-up of patients with HF, eHealth interventions can positively affect QoL, whereas its impact is less evident for self-care and readmissions. Conclusions This review suggests that patients with HF should receive prompt follow-up after hospitalization and eHealth interventions have the potential to improve these patients’ QoL. Patient adherence in eHealth follow-up trials shows promise for successful future interventions and adherence research. Further studies are warranted to examine the effects of eHealth interventions on self-care and readmissions among patients with HF.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Posthospitalization Follow-Up of Patients With Heart Failure Using eHealth Solutions: Restricted Systematic Review

Husebø¹,

Storm²,

Urstad³

et al. 2022

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…Quadruple Aim). Although most evidence syntheses report mostly positive outcomes (Bashi et al, 2017;Clark et al, 2007;Farias et al, 2020;Nick et al, 2021;Pandor et al, 2013;Taylor et al, 2021;Vegesna et al, 2017), others have also reported mostly null, inconclusive, or underwhelming results (Auener et al, 2021;Baltaxe et al, 2019;Flodgren et al, 2015;Noah et al, 2018). A common limitation is that RPM programmes can vary greatly, including the modality, timing, and types of data collection/transfer, the degree to which RPM is incorporated into routine care, and the investment in implementation supports such as patient and provider training (Flodgren et al, 2015;Nick et al, 2021;Vegesna et al, 2017).…”

Section: Remote Patient Monitoringmentioning

confidence: 99%

“…, 2021; Vegesna et al. , 2017), others have also reported mostly null, inconclusive, or underwhelming results (Auener et al. , 2021; Baltaxe et al.…”

Section: Introductionmentioning

confidence: 99%

A maturity model framework for integrated virtual care

Sinn

Pasat

Klea³

et al. 2022

JICA

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PurposeRemote patient monitoring (RPM) and virtual visits have the potential to transform care delivery and outcomes but require intentional planning around how these technologies contribute to integrated care. Since maturity models are useful frameworks for understanding current performance and motivating progress, the authors developed a model describing the features of RPM that can advance integrated care.Design/methodology/approachThis work was led by St. Joseph's Health System Centre for Integrated Care in collaboration with clinical and programme leads and frontline staff offering RPM services as part of Connected Health Hamilton in Ontario, Canada. Development of the maturity model was informed by a review of existing telehealth maturity models, online stakeholder meetings, and online interviews with clinical leads, programme leads, and staff.FindingsThe maturity model comprises 4 maturity levels and 17 sub-domains organised into 5 domains: Technology, Team Organisation, Programme Support, Integrated Information Systems, and Performance and Quality. An implementation pillars checklist identifies additional considerations for sustaining programmes at any maturity level. Finally, the authors apply one of Connected Health Hamilton's RPM programmes to the Team Organisation domain as an example of the maturity model in action.Originality/valueThis work extends previous telehealth maturity models by focussing on the arrangement of resources, teams, and processes needed to support the delivery of integrated care. Although the model is inspired by local programmes, the model is highly transferable to other RPM programmes.

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“…A capitated telehealth coaching service did not reduce hospital readmissions; however, there was a reduction in acute hospital bed days [ 3 ]. In patients with heart failure, a systematic review found that a reduction in hospitalizations was accompanied by an increase in nonemergency outpatient visits [ 4 ]. Glycemic therapy frequently requires revision during hospital stay [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Acceptance and Effect of Continuous Glucose Monitoring on Discharge From Hospital in Patients With Type 2 Diabetes: Open-label, Prospective, Controlled Study

Depczynski¹,

Poynten²

2022

JMIR Diabetes

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Background Continuous glucose monitors (CGM) can provide detailed information on glucose excursions. There is little information on safe transitioning from hospital back to the community for patients who have had diabetes therapies adjusted in hospital and it is unclear whether newer technologies may facilitate this process. Objective Our aim was to determine whether offering CGM on discharge would be acceptable and if CGM initiated on hospital discharge in people with type 2 diabetes (T2DM) would reduce hospital re-presentations at 1 month. Methods This was an open-label study. Adult inpatients with T2DM, who were to be discharged home and required postdischarge glycemic stabilization, were offered usual care consisting of clinic review at 2 weeks and at 3 months. In addition to usual care, participants in the intervention arm were provided with a Libre flash glucose monitoring system (Abbott Australia). An initial run-in phase for the first 20 participants was planned, where all consenting participants were enrolled in an active arm. Subsequently, all participants were to be randomized to the active arm or usual care control group. Results Of 237 patients screened during their hospital admission, 34 had comorbidities affecting cognition that prevented informed consent and affected their ability to learn to use the CGM device. In addition, 21 were not able to be approached as the material was only in English. Of 101 potential participants who fulfilled eligibility criteria, 19 provided consent and were enrolled. Of the 82 patients who declined to participate, 31 advised that the learning of a new task toward discharge was overwhelming or too stressful and 26 were not interested, with no other details. Due to poor recruitment, the study was terminated without entering the randomization phase to determine whether CGM could reduce readmission rate. Conclusions These results suggest successful and equitable implementation of telemedicine programs requires that any human factors such as language, cognition, and possible disengagement be addressed. Recovery from acute illness may not be the ideal time for introduction of newer technologies or may require more novel implementation frameworks.

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The Effect of Noninvasive Telemonitoring for Chronic Heart Failure on Health Care Utilization: Systematic Review

Cited by 22 publications

References 58 publications

Posthospitalization Follow-Up of Patients With Heart Failure Using eHealth Solutions: Restricted Systematic Review

Posthospitalization Follow-Up of Patients With Heart Failure Using eHealth Solutions: Restricted Systematic Review

A maturity model framework for integrated virtual care

Acceptance and Effect of Continuous Glucose Monitoring on Discharge From Hospital in Patients With Type 2 Diabetes: Open-label, Prospective, Controlled Study

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