Subscribe to RSS
Evaluating the Effect of Monitoring through Telephone (Tele-Monitoring) on Self-Care Behaviors and Readmission of Patients with Heart Failure after DischargeFunding This study was part of an MSc thesis supported by the Tehran University of Medical Sciences (Grant No: 33181).
17 October 2018
28 February 2019
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.
- 1 Brunner LS, Smeltzer SCC, Bare BG, Hinkle JL, Cheever KH. Brunner & Suddarth's Textbook of Medical-Surgical Nursing. Philadelphia, PA: Lippincott Williams & Wilkins; 2010: 257-281
- 2 McMurray JJ, Adamopoulos S, Anker SD. , et al; Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology; ESC Committee for Practice Guidelines. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 2012; 14 (08) 803-869
- 3 Savarese G, Lund LH. Global public health burden of heart failure. Card Fail Rev 2017; 3 (01) 7-11
- 4 Rajadurai J, Tse H-F, Wang C-H, Yang N-I, Zhou J, Sim D. Understanding the epidemiology of heart failure to improve management practices: an Asia-Pacific perspective. J Card Fail 2017; 23 (04) 327-339
- 5 Givi M, Shafie D, Nouri F, Garakyaraghi M, Yadegarfar G, Sarrafzadegan N. Survival rate and predictors of mortality in patients hospitalised with heart failure: a cohort study on the data of Persian registry of cardiovascular disease (PROVE). Postgrad Med J 2018; 94 (1112): 318-324
- 6 Ahmadi A, Soori H, Mobasheri M, Etemad K, Khaledifar A. Heart failure, the outcomes, predictive and related factors in Iran. Majallah-i Danishgah-i Ulum-i Pizishki-i Mazandaran 2014; 24 (118) 180-188
- 7 Lesyuk W, Kriza C, Kolominsky-Rabas P. Cost-of-illness studies in heart failure: a systematic review 2004-2016. BMC Cardiovasc Disord 2018; 18 (01) 74
- 8 Ditewig JB, Blok H, Havers J, van Veenendaal H. Effectiveness of self-management interventions on mortality, hospital readmissions, chronic heart failure hospitalization rate and quality of life in patients with chronic heart failure: a systematic review. Patient Educ Couns 2010; 78 (03) 297-315
- 9 Buck HG, Harkness K, Wion R. , et al. Caregivers' contributions to heart failure self-care: a systematic review. Eur J Cardiovasc Nurs 2015; 14 (01) 79-89
- 10 Jaarsma T, Strömberg A, Mårtensson J, Dracup K. Development and testing of the European Heart Failure Self-Care Behaviour Scale. Eur J Heart Fail 2003; 5 (03) 363-370
- 11 Jackson JD, Cotton SE, Bruce Wirta S. , et al. Burden of heart failure on patients from China: results from a cross-sectional survey. Drug Des Devel Ther 2018; 12: 1659-1668
- 12 Shojaee A, Nehrir B, Naderi N, Zareiyan A. Effect of patient education and telephone follow up by the nurse on the level of hope in patients suffering from heart failure. 2013. J Nurs Educ 2013; 3 (02) 16-26
- 13 Bashi N, Karunanithi M, Fatehi F, Ding H, Walters D. Remote monitoring of patients with heart failure: an overview of systematic reviews. J Med Internet Res 2017; 19 (01) e18
- 14 Paré G, Moqadem K, Pineau G, St-Hilaire C. Clinical effects of home telemonitoring in the context of diabetes, asthma, heart failure and hypertension: a systematic review. J Med Internet Res 2010; 12 (02) e21
- 15 Paré G, Jaana M, Sicotte C. Systematic review of home telemonitoring for chronic diseases: the evidence base. J Am Med Inform Assoc 2007; 14 (03) 269-277
- 16 McGonigle D, Mastrian K. Nursing Informatics and the Foundation of Knowledge. Burlington, MA: Jones & Bartlett Publishers; 2014
- 17 Khodadadi A, Sayadi A, Smaeli H. Evolution of Knowledge of the principles of self care in acute coronary syndrome patients admitted to Aliebn Abitaleb Rafsanjan university hospital during 2009. Community Health Journal. 2010; 5 (01) 8-16 (Persian)
- 18 Passyavula SK. Telemedicine, telenursing & tele education - a revolution multi innovation in current nursing scenario. International Journal Of Medical And Health Research. 2016; 2 (05) 31-32
- 19 Boroumand S, Moeini M. The effect of a text message and telephone follow-up program on cardiac self-efficacy of patients with coronary artery disease: a randomized controlled trial. Iran J Nurs Midwifery Res 2016; 21 (02) 171-176
- 20 Tse G, Chan C, Gong M. , et al; International Health Informatics Study (IHIS) Network. Telemonitoring and hemodynamic monitoring to reduce hospitalization rates in heart failure: a systematic review and meta-analysis of randomized controlled trials and real-world studies. J Geriatr Cardiol 2018; 15 (04) 298
- 21 Hayakawa M, Uchimura Y, Omae K, Waki K, Fujita H, Ohe K. A smartphone-based medication self-management system with real-time medication monitoring. Appl Clin Inform 2013; 4 (01) 37-52
- 22 Clarke M, Shah A, Sharma U. Systematic review of studies on telemonitoring of patients with congestive heart failure: a meta-analysis. J Telemed Telecare 2011; 17 (01) 7-14
- 23 Tice JA. , ed. Home Telemonitoring for the Management of Heart Failure. San Francisco, CA: California Technology Assessment Forum; 2011
- 24 Tripoliti EE, Papadopoulos TG, Karanasiou GS. , et al , eds. Estimation of New York Heart Association Class in Heart Failure Patients Based on Machine Learning Techniques. Presented in the 2017 IEEE EMBS International Conference on Biomedical & Health Informatics, 2017 ;16(19)
- 25 Heidari M, Sarvandian S, Moradbeigi K, Akbari Nassaji N, Vafaizadeh M. Comparing the effect of telenursing and education without follow-up in the caregivers of heart failure patients on the self-care behavior and clinical status of heart failure patients. J Hayat 2017; 23 (01) 44-58
- 26 Baghiani Moghadam MH, Taheri G, Fallah Zadeh H, Parsa M. The effect of instructional designed SMS based on Health Belief Model (HBM) on adoption of self-care behavior of patients with type II diabetes. Modern Care J 2014; 11 (01) 10-18
- 27 Jaarsma T, Strömberg A, Ben Gal T. , et al. Comparison of self-care behaviors of heart failure patients in 15 countries worldwide. Patient Educ Couns 2013; 92 (01) 114-120
- 28 Riley JP, Gabe JP, Cowie MR. Does telemonitoring in heart failure empower patients for self-care? A qualitative study. J Clin Nurs 2013; 22 (17-18): 2444-2455
- 29 Jaana M, Sherrard H, Paré G. A prospective evaluation of telemonitoring use by seniors with chronic heart failure: adoption, self-care, and empowerment. Health Informatics J 2018 Doi: 10.1177/1460458218799458
- 30 Chaudhry SI, Mattera JA, Curtis JP. , et al. Telemonitoring in patients with heart failure. N Engl J Med 2010; 363 (24) 2301-2309
- 31 Ong MK, Romano PS, Edgington S. , et al; Better Effectiveness After Transition–Heart Failure (BEAT-HF) Research Group. Effectiveness of remote patient monitoring after discharge of hospitalized patients with heart failure: the Better Effectiveness after Transition -- Heart Failure (BEAT-HF) Randomized Clinical Trial. JAMA Intern Med 2016; 176 (03) 310-318
- 32 Bento VFR, Brofman PRS. Impact of the nursing consultation on the frequency of hospitalizations in patients with heart failure in Curitiba, Parana State. Arq Bras Cardiol 2009; 92 (06) 490-496
- 33 Delaney C, Apostolidis B, Bartos S, Morrison H, Smith L, Fortinsky R. A randomized trial of tele-monitoring and self-care education in heart failure patients following home care discharge. Home Health Care Manage Pract 2013; 25 (05) 187-195
- 34 Chiu CW, Wong FK. Effects of 8 weeks sustained follow-up after a nurse consultation on hypertension: a randomised trial. Int J Nurs Stud 2010; 47 (11) 1374-1382