Does Telemonitoring Reduce HF Readmissions?

In patients hospitalized for heart failure (HF), health coaching telephone calls and telemonitoring did not reduce 180-day readmissions, according to a study published Feb. 8 in JAMA Internal Medicine.

The study looked at 1,437 patients hospitalized with HF who were randomized to an intervention arm – which consisted of combined health coaching telephone calls and telemonitoring – or usual care, and were observed for 180 days.

Results showed that the intervention and usual care groups “did not differ significantly” in readmissions for any cause 180 days after discharge (50.8 percent and 49.2 percent, respectively). Further, there were “no significant differences in 30-day readmissions or 180-day mortality, but there was a significant difference in 180-day quality of life between the intervention and usual care groups.”

The authors note that one possible explanation for their results may be that all participating sites were already focused on readmissions among patients with HF “because of the impending potential penalties from the Hospital Readmission Program and had implemented readmission reduction efforts.”

The authors ultimately conclude that the combination of remote patient monitoring with care transition management did not reduce 180-day all-cause readmission after hospitalization for HF, but moving forward, further studies are needed to confirm their findings.

In a related editorial comment, Kumar Dharmarajan, MD, MBA, and Sarwat I. Chaudhry, MD, add that “These findings suggest that further reductions in readmissions in HF will require novel approaches that enhance the effectiveness of telemonitoring or target newly recognized pathways to readmission, such as common hospital stressors or the persistence of symptoms experienced by patients after hospital discharge.” They add that “whatever format such strategies take place, patients must participate in their formation so that they address the issues that matter most to them in an efficient and sustainable manner.” 

Clinical Topics: Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: Disease Management, Heart Failure, Hospitalization, Hospitals, Monitoring, Physiologic, Patient Discharge, Patient Readmission, Patient Transfer, Quality of Life, Telephone

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