Telehealth Protocol to Prevent Readmission Among High-Risk Patients With Congestive Heart FailureRosen, D and McCall, Janice and Primack, BA (2017) Telehealth Protocol to Prevent Readmission Among High-Risk Patients With Congestive Heart Failure. The American Journal of Medicine, 130 (11). pp. 1326-1330.
AbstractBackground. Congestive heart failure (CHF) is the leading cause of hospital readmissions. We aimed to assess adherence to and effectiveness of a telehealth protocol designed to prevent hospital admissions for CHF. Methods. We recruited a random sample of 50 patients with CHF (mean age 61). We developed a telehealth platform allowing for daily real-time reporting of health status and video conferencing. We defined adherence as the percentage of days on which the patient completed the intervention. To assess efficacy, we compared admission and readmission rates between the 6-month intervention period and the prior 6 months. Primary outcomes were admissions and readmissions due to CHF, and secondary outcomes were admissions and readmissions due to all causes. Results. Forty-eight (96%) patients completed the protocol. About half (46%) were at high risk for readmission based on standardized measures. Median 120-day adherence was 96% (interquartile range=92-98%), and adherence did not significantly differ across sex, race, age, living situation, depression, cognitive ability, or risk for readmission. CHF-specific admissions were 53% lower during the intervention period compared with the control period (7 vs. 15, P=.007), and CHF-specific readmissions were 83% lower (1 vs. 6, P=.01). When comparing the intervention and control periods, all-cause admissions and readmissions were 25% and 57% lower (P=.01 and P=.006, respectively). Conclusion. Adherence to this telehealth protocol was excellent and consistent, even among high-risk patients. The protocol was associated with a significant decrease in CHF-related and all-cause admissions and readmissions. Future research should test the protocol using a more rigorous randomized design. Share
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