TY - JOUR
T1 - The effects of telemonitoring on patient compliance with self-management recommendations and outcomes of the innovative telemonitoring enhanced care program for chronic heart failure
T2 - Randomized controlled trial
AU - Ding, Hang
AU - Jayasena, Rajiv
AU - Chen, Sheau Huey
AU - Maiorana, Andrew
AU - Dowling, Alison
AU - Layland, Jamie
AU - Good, Norm
AU - Karunanithi, Mohanraj
AU - Edwards, Iain
N1 - Funding Information:
The authors gratefully acknowledge (1) the members of the Project Control Board, including Mr David Anderson, Dr Phil Carrillo, Dr Fergus McGee, and Mr Mark Gravell for their management and guidance in the clinical trial; (2) the members of MEPACS, including Mr Dean Richardson and Mr Dhruv Singh, for implementing the telemonitoring system and managing the call service in the clinical trial; (3) the members of Medtech Global, including Mr Rama Kumble and GK Shridhar, for implementing and managing the telemonitoring system in the clinical trial; and (4) nursing and medical support provided by Julie Smith and Dr Matthew Best from the trial site in WA. This project is fully funded by the health market validation program by the Department of State Development, Business and Innovation, Victorian government (121 Exhibition Street, Melbourne, Vic, 3001, Australia. The contract was signed in May 2014), and the Western Australia Targeted Research Fund Grant by the Department of Health, WA (notification, February 4, 2014). These funding sponsors will not have any role in the design of this study, execution of the trial, analysis and interpretation of the trial data, and research publications.
Publisher Copyright:
© Hang Ding, Rajiv Jayasena, Sheau Huey Chen, Andrew Maiorana, Alison Dowling, Jamie Layland, Norm Good, Mohanraj Karunanithi, Iain Edwards.
PY - 2020/7/8
Y1 - 2020/7/8
N2 - Background: Telemonitoring enables care providers to remotely support outpatients in self-managing chronic heart failure (CHF), but the objective assessment of patient compliance with self-management recommendations has seldom been studied. Objective: This study aimed to evaluate patient compliance with self-management recommendations of an innovative telemonitoring enhanced care program for CHF (ITEC-CHF). Methods: We conducted a multicenter randomized controlled trial with a 6-month follow-up. The ITEC-CHF program comprised the provision of Bluetooth-enabled scales linked to a call center and nurse care services to assist participants with weight monitoring compliance. Compliance was defined a priori as weighing at least 4 days per week, analyzed objectively from weight recordings on the scales. The intention-to-treat principle was used to perform the analysis. Results: A total of 184 participants (141/184, 76.6% male), with a mean age of 70.1 (SD 12.3) years, were randomized to receive either ITEC-CHF (n=91) or usual care (control; n=93), of which 67 ITEC-CHF and 81 control participants completed the intervention. For the compliance criterion of weighing at least 4 days per week, the proportion of compliant participants in the ITEC-CHF group was not significantly higher than that in the control group (ITEC-CHF: 67/91, 74% vs control: 56/91, 60%; P=.06). However, the proportion of ITEC-CHF participants achieving the stricter compliance standard of at least 6 days a week was significantly higher than that in the control group (ITEC-CHF: 41/91, 45% vs control: 23/93, 25%; P=.005). Conclusions: ITEC-CHF improved participant compliance with weight monitoring, although the withdrawal rate was high. Telemonitoring is a promising method for supporting both patients and clinicians in the management of CHF. However, further refinements are required to optimize this model of care.
AB - Background: Telemonitoring enables care providers to remotely support outpatients in self-managing chronic heart failure (CHF), but the objective assessment of patient compliance with self-management recommendations has seldom been studied. Objective: This study aimed to evaluate patient compliance with self-management recommendations of an innovative telemonitoring enhanced care program for CHF (ITEC-CHF). Methods: We conducted a multicenter randomized controlled trial with a 6-month follow-up. The ITEC-CHF program comprised the provision of Bluetooth-enabled scales linked to a call center and nurse care services to assist participants with weight monitoring compliance. Compliance was defined a priori as weighing at least 4 days per week, analyzed objectively from weight recordings on the scales. The intention-to-treat principle was used to perform the analysis. Results: A total of 184 participants (141/184, 76.6% male), with a mean age of 70.1 (SD 12.3) years, were randomized to receive either ITEC-CHF (n=91) or usual care (control; n=93), of which 67 ITEC-CHF and 81 control participants completed the intervention. For the compliance criterion of weighing at least 4 days per week, the proportion of compliant participants in the ITEC-CHF group was not significantly higher than that in the control group (ITEC-CHF: 67/91, 74% vs control: 56/91, 60%; P=.06). However, the proportion of ITEC-CHF participants achieving the stricter compliance standard of at least 6 days a week was significantly higher than that in the control group (ITEC-CHF: 41/91, 45% vs control: 23/93, 25%; P=.005). Conclusions: ITEC-CHF improved participant compliance with weight monitoring, although the withdrawal rate was high. Telemonitoring is a promising method for supporting both patients and clinicians in the management of CHF. However, further refinements are required to optimize this model of care.
KW - Digital health
KW - Heart failure
KW - Patient compliance
KW - Randomized controlled trial
KW - Remote monitoring
KW - Telemonitoring
UR - http://www.scopus.com/inward/record.url?scp=85088157081&partnerID=8YFLogxK
U2 - 10.2196/17559
DO - 10.2196/17559
M3 - Article
C2 - 32673222
AN - SCOPUS:85088157081
SN - 1439-4456
VL - 22
JO - Journal of Medical Internet Research
JF - Journal of Medical Internet Research
IS - 7
M1 - e17559
ER -