Effectiveness of telemonitoring-enhanced support over structured telephone support in reducing heart failure-related healthcare utilization in a multi-ethnic Asian setting

Abstract

Aims Our study aimed to compare the effectiveness of telemonitoring over structured telephone support in reducing heart failure-related healthcare utilization. Methods This was a non-randomised controlled study comparing 150 recently discharged heart failure patients enrolled into telemonitoring and 55 patients who only received structured telephone support after rejecting telemonitoring. Patient activation, knowledge and self-management levels were measured at baseline and the one year upon programme completion using the Patient Activation Measure, the Dutch Heart Failure Knowledge Scale and the Self-Care of Heart Failure Index respectively. Differences in heart failure-related and all-cause hospitalization rates, total bed days and mortality rates at 180 days and at one year, knowledge and self-management scores and total cost of care between groups at one year were analysed. Results Average age of telemonitoring was 57.9 years and 63.9 years for structured telephone support. Significant difference in adjusted 180-day all-cause bed days (telemonitoring: five days versus structured telephone support: 9.8 days), heart failure-related bed days (telemonitoring: 1.2 days versus structured telephone support: six days) and adjusted one-year heart failure-related bed days (telemonitoring: 2.2 days versus structured telephone support: 6.6 days) were observed. Telemonitoring was associated with reduced all-cause one-year mortality (hazard ratio 0.32, p = 0.02). Estimated mean maintenance and confidence scores were significantly higher in the telemonitoring group at one year. No differences in all-cause and HF-related readmission rates and knowledge levels were observed. The one-year total cost of care was predicted to be Singapore dollars (SG$) 2774.4 lower ( p = 0.07) in telemonitoring. Conclusion In conclusion, telemonitoring was associated with lower all-cause and heart failure-related total bed days at 180 days, lower heart failure-related total bed days and total cost of care at one year as compared with structured telephone support.

Measures of Engagement With mHealth Interventions in Patients With Heart Failure: Scoping Review

“…Of the 32 studies, 16 (50%) [ 14 , 34 - 48 ] were conducted in the United States. The remaining studies were conducted in Germany (3/32, 9%) [ 49 - 51 ], Canada (2/32, 6%) [ 14 , 52 ], Belgium (2/32, 6%) [ 53 , 54 ], Italy (2/32, 6%) [ 55 , 56 ], the United Kingdom (1/32, 3%) [ 57 ], Austria (1/32, 3%) [ 58 ], Sweden (1/32, 3%) [ 59 ], Poland (1/32, 3%) [ 60 ], Singapore (1/32, 3%) [ 61 ], China (1/32, 3%) [ 62 ], and Australia (1/32, 3%) [ 63 ]. The duration of the studies ranged from 1 to 26 months, with a median of 3 months.…”

“…The key characteristics of the interventions are presented in ( Multimedia Appendix 3 ). In approximately 50% (16/32) of the studies [ 14 , 35 , 38 , 40 , 43 , 45 , 47 - 49 , 52 - 55 , 57 , 58 , 60 ], patients used smartphones, 28% (9/32) [ 36 , 37 , 39 , 42 , 46 , 59 , 61 - 63 ] used tablet computers, 6.25% (2/32) [ 50 , 56 ] used PDAs, and 16% (5/32) used either portable telemonitoring devices [ 34 , 44 ] or a combination of smartphones, smart watches, and tablet computers [ 45 , 51 , 64 ] as integral components of mHealth systems for the management of HF symptoms or for the provision of HF-related self-care education.…”

“…The operational definitions differed across the 30 studies that reported the metric. In 47% (14/30) of the 30 studies, system usage data were operationalized as the proportion of patients who used an mHealth system to complete 70% [ 49 , 50 ], 80% [ 52 ], 85% [ 61 ], or 100% [ 36 , 38 , 40 , 42 , 48 , 60 - 64 ] of the required tasks as expected during the duration of intervention or system use. The engagement levels reported in the 14 studies ranged from 45% [ 63 ] to 100% [ 60 ].…”

A (I) Legitimidade Da Recusa Dos Pais Em Vacinarem Seus Filhos Por Motivos De Convicções Filosóficas: Uma Abordagem a Partir Das Concepções De J. S. Mill E Robert Nozick

“…Outro termo que podemos citar seria o telemonitoramento, que consiste em realizar um acompanhamento remoto de dados de saúde do local onde o paciente se encontra até um centro especializado de monitoramento, interpretação e análisepor meio de uso de tecnologias de comunicação e, assim, garantir a sua promoção e prevenção da saúde (Paré G, Jaana M, Sicotte C, 2007). Ele já foi muito usado nos artigos encontrados nesta pesquisa (CHI, Nai-Ching;DE-MIRIS, George, 2015;KITSIOU, Spyros, 2015;MURPHIE, Phyllis, 2019;PIGA, Matteo et al;GHOLAMZADEH, Marsa;ABTAHI, Hamidreza;SAFDARI, Reza, 2022;LENG CHOW, Wai et al, 2020;BANBURY, Annie et al;, e muitos mostram que usam as tecnologias de comunicação para conseguir acompanhar e, consequentemente, manter a adesão dos pacientes ao medicamentos ou ao tratamento de várias doenças diferentes no contexto em que estão in-seridos. Isso torna uma peça fundamental para a saúde em tempos cibernéticos.…”

Impacto Da Pandemia Do Covid-19 Na Prevalência De Doenças Dermatológicas No Ambulatório De Um Centro Universitário

“…In: Anuário Brasileiro de Segurança Pública. p. [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]2021. Disponível em https:// forumseguranca.org.br/anuario-brasileiro-seguranca-publica/.Acesso em 09 de fev de 2022.…”