Patient Compliance in Home-Based Self-Care Telehealth Projects

Abstract

This paper presents the findings of a literature review on patient compliance in home-based self-care telehealth monitoring situations, intended to establish a knowledge base for this aspect which is often neglected alongside more conventional clinical, economic and service evaluations. A systematic search strategy led to 72 peer-reviewed published scientific papers being selected as most relevant to the topic, 58 of which appeared in the last 10 years. Patient conditions in which most evidence for compliance was found were blood pressure, heart failure and stroke, diabetes, asthma, chronic obstructive pulmonary disease and other respiratory diseases. In general, good compliance at the start of a study was found to drop off over time, most rapidly in the period immediately after the start. Success factors identified in the study included the extent of patient health education, telehealth system implementation style, user training and competence in system usage, active human support from the healthcare provider and maintaining strong participant motivation.

The challenge of involving elderly patients in primary care by using an electronic communication tool with their professionals: a mixed methods study

“…Continual support is important to them which may be why they were motivated to use Congredi 32. Human support from the provider has been shown to increase compliance, but it was not examined how often the patient-systems were proactively urged to use Congredi 33. In further implementation, this aspect needs attention.…”

Patient Adherence to Scheduled Vital Sign Measurements During Home Telemonitoring: Analysis of the Intervention Arm in a Before and After Trial (Preprint)

“…This drop is more evident in the first few weeks or months immediately after the start. Moreover, higher compliance rates have been reported for simple types of monitoring and for shorter periods of intervention [6]. As an illustration, while compliance rates of 89% were reported by Port et al, [29] for the first two months, this rate dropped to around 50% within 10 months.…”

“…According to the systematic review undertaken by Maeder et al [6], the compliance rate usually dropped off steadily over time, in most of the studies, and this drop is more evident in the first few weeks or months immediately after the start. Although it is evident from our results that the overall compliance rate dropped off in the first 3 month, it did not continue to fall and indeed recovered over time.…”

“…Large healthcare organizations, such as the Veterans Administration in the USA, or the National Health Service (NHS) in the UK, have already adopted a range of telehealth solutions [6]. The ageing population and the increasing burden of chronic disease, together with the availability of low cost monitoring technology have resulted in increasing interest in deploying telehealth services for the management of patients with chronic conditions and an increasing market demand worldwide for telehealth services.…”

“…Other studies on the compliance and effectiveness of at home telemonitoring [27] report that over one year compliance rates with recording weight was 75% and for the recording of blood pressure, 90%, whilst another study [28] reports values of 12-75% for compliance with daily weighing for CHF patients. According to Maeder et al, [6], reported levels of compliance varied from approximately 40% to 90%. In most of these studies, the compliance rate usually dropped off steadily over time.…”