Appl Clin Inform 2019; 10(02): 261-268
DOI: 10.1055/s-0039-1685167
Research Article
Georg Thieme Verlag KG Stuttgart · New York

Evaluating the Effect of Monitoring through Telephone (Tele-Monitoring) on Self-Care Behaviors and Readmission of Patients with Heart Failure after Discharge

Reza Negarandeh
1  Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
Mitra Zolfaghari
2  Department of E-Learning in Medical Education, Tehran University of Medical Sciences, Virtual School, Tehran, Iran
Nazli Bashi
3  The Australian E-Health Research Center, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Australia
Maryam Kiarsi
4  Department of Nursing & Emergency Medicine, Dezful University of Medical Sciences, Dezful, Iran
› Author Affiliations
Funding This study was part of an MSc thesis supported by the Tehran University of Medical Sciences (Grant No: 33181).
Further Information

Publication History

17 October 2018

28 February 2019

Publication Date:
17 April 2019 (online)


Background Heart failure is one of the serious cardiovascular diseases, which poses a global pandemic and places a heavy burden on health care systems worldwide. The incidence of this disease in Iran is higher than in other Asian countries. To reduce patients' complications, readmission rates, and health care expenditures, it is necessary to design interventions, which are culturally appropriate and based on community needs.

Methods In 2016, a randomized clinical trial (IRCT2017010731804N1) was initiated to compare tailored tele-monitoring intervention with usual care. In total, 80 patients completed the study after a follow-up period of 8 weeks. The primary end point was heart failure self-care, which was measured using the Iranian version of the European Heart Failure self-care questionnaire. Secondary end points were heart failure related readmission rates.

Results The mean scores for self-care behaviors of the two groups showed significant difference at the baseline (p = 0.045). The results of the analysis of covariance that was used to control the differences in the pretest scores of self-care behaviors showed that the difference between both groups after the intervention was still significant (p < 0.001). The percentage of patients' readmissions in the intervention group (20%) was less than that in the control group (42.2%); however, the results were not statistically significant (p = 0/066).

Conclusion This study showed that tele-monitoring improved self-care behaviors in Iranian patients with heart failure but did not reduce their readmission rates.

Protection of Human and Animal Subjects

This study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and was reviewed by the Tehran University of Medical Sciences' Ethics Committee with approval ID: IR.TUMS.VCR.REC.1395.938.