Better Effectiveness After Transition–Heart Failure - BEAT-HF

Feb 08, 2016
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Author/Summarized by Author:
Anthony A. Bavry, MD, MPH, FACC
Summary Reviewer:
Deepak L. Bhatt, MD, MPH, MBA, FACC
Trial Sponsor:
Agency for Healthcare Research and Quality; National Heart, Lung, and Blood Institute; National Center for Advancing Translational Science; UCLA CTSI; Robert Wood Johnson Foundation; Sierra Health Foundation; University of California Center for Health Quality and Innovation
Date Presented:
11/08/2015
Date Published:
02/08/2016
Date Updated:
02/08/2016
Original Posted Date:
02/08/2016
References

Description:

The goal of the trial was to evaluate the effectiveness of remote patient management among patients recently hospitalized for heart failure.

Contribution to the Literature: The BEAT-HF trial failed to show that telephone coaching and telemonitoring reduced hospitalizations.

Study Design

  • Randomized
  • Parallel

Patients hospitalized for heart failure were randomized to an intervention group (n = 715) versus control (n = 722). The intervention group consisted of pre-discharge hospital education, regularly scheduled telephone coaching, and telemonitoring of heart rate, blood pressure, weight, and symptoms.

Inclusion criteria:

  • Patients ≥50 years of age hospitalized for decompensated heart failure

Exclusion criteria:

  • Total number of enrollees: 1,437
  • Duration of follow-up: 180 days
  • Median patient age: 73 years
  • Percentage female: 46%

Principal Findings:

Readmission for any cause at 180 days occurred in 51% of the group intervention vs. 49% of the control group (p = 0.74).

Secondary outcomes:

  • Readmission at 30 days: 23% vs. 22% (p = 0.63), respectively for intervention vs. control
  • Mortality at 30 days: 3.4% vs. 5.4% (p = 0.06), respectively for intervention vs. control
  • Mortality at 180 days: 14% vs. 16% (p = 0.34), respectively for intervention vs. control

Interpretation:

Among individuals hospitalized with decompensated heart failure, an intervention with telephone coaching and telemonitoring did not reduce rehospitalization at 180 days. Early mortality was nonsignificantly reduced in the intervention group; however, this benefit was no longer apparent at 180 days. Multiple large randomized trials have failed to demonstrate a convincing benefit with telemonitoring among heart failure patients.

References:

Ong MK, Romano PS, Edgington S, et al. 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;Feb 8:[Epub ahead of print].

Presented by Dr. Michael K. Ong at the American Heart Association Scientific Sessions, Orlando, FL, November 8, 2015.

Keywords: Blood Pressure, Disease Management, Heart Failure, Heart Rate, Hospitalization, Intervention Studies, Mortality, Patient Discharge, Patient Readmission, Primary Prevention, Telephone, AHA Annual Scientific Sessions


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