Posthospitalization Follow-Up of Patients With Heart Failure Using eHealth Solutions: Restricted Systematic Review

Abstract

Background Heart failure (HF) is a clinical syndrome with high incidence rates, a substantial symptom and treatment burden, and a significant risk of readmission within 30 days after hospitalization. The COVID-19 pandemic has revealed the significance of using eHealth interventions to follow up on the care needs of patients with HF to support self-care, increase quality of life (QoL), and reduce readmission rates during the transition between hospital and home. Objective The aims of this review are to summarize research on the content and delivery modes of HF posthospitalization eHealth interventions, explore patient adherence to the interventions, and examine the effects on the patient outcomes of self-care, QoL, and readmissions. Methods A restricted systematic review study design was used. Literature searches and reviews followed the (PRISMA-S) Preferred Reporting Items for Systematic Reviews and Meta-Analyses literature search extension checklist, and the CINAHL, MEDLINE, Embase, and Cochrane Library databases were searched for studies published between 2015 and 2020. The review process involved 3 groups of researchers working in pairs. The Mixed Methods Appraisal Tool was used to assess the included studies’ methodological quality. A thematic analysis method was used to analyze data extracted from the studies. Results A total of 18 studies were examined in this review. The studies were published between 2015 and 2019, with 56% (10/18) of them published in the United States. Of the 18 studies, 16 (89%) were randomized controlled trials, and 14 (78%) recruited patients upon hospital discharge to eHealth interventions lasting from 14 days to 12 months. The studies involved structured telephone calls, interactive voice response, and telemonitoring and included elements of patient education, counseling, social and emotional support, and self-monitoring of symptoms and vital signs. Of the 18 studies, 11 (61%) provided information on patient adherence, and the adherence levels were 72%-99%. When used for posthospitalization follow-up of patients with HF, eHealth interventions can positively affect QoL, whereas its impact is less evident for self-care and readmissions. Conclusions This review suggests that patients with HF should receive prompt follow-up after hospitalization and eHealth interventions have the potential to improve these patients’ QoL. Patient adherence in eHealth follow-up trials shows promise for successful future interventions and adherence research. Further studies are warranted to examine the effects of eHealth interventions on self-care and readmissions among patients with HF.

Telemedicine for Kidney Transplant Recipients: Current State, Advantages, and Barriers

“…Their remote care often includes elements of patient education, counseling, and social and emotional support. 93 In the future, we expect that transplant recipients will be able to become more self-sufficient in their treatment and possibly certain patient groups may only reach out to professionals in case of problems. Studies are needed to investigate the extent to which transplant recipients are willing and able to achieve such a high degree of self-sufficiency through telemedicine and the openness of professionals to this approach.…”

Platform-Based Patient-Clinician Digital Health Interventions for Care Transitions: Protocol for a Scoping Review

“…Engaging patients in their care through digital health interventions is possible given the widespread use of internet-based personal communication devices [ 5 ] and the effective use of such interventions with patients and their clinicians. Although asynchronous digital platforms can sometimes be challenging, especially in relation to technological issues [ 6 ], successful use of these platforms has been described with patients living with diabetes [ 7 , 8 ], cardiovascular disease [ 9 , 10 ], chronic obstructive pulmonary disease [ 11 ], and patients recovering post surgery [ 12 - 14 ].…”

Assessing a nurse-assisted eHealth intervention posthospital discharge in adult patients with non-communicable diseases: a protocol for a feasibility study

“…This enables nurses and other care providers to provide timely, clinical intervention. Remote monitoring combined with eHealth support has proven efficient in increasing self-care and reducing costly readmissions, which can be critical and burdensome for patients 19 20. Self-management may be particularly challenging during transitional phases, for example, shifts from one life phase or status to another,21 such as the transition from hospital to home.…”

“…Self-management may be particularly challenging during transitional phases, for example, shifts from one life phase or status to another,21 such as the transition from hospital to home. Interventions specifically designed to close the transitional gap between hospital discharge and home, combining remote monitoring and eHealth, may have the potential to improve both timely clinical intervention and patient engagement in self-care, as well as to reduce readmissions and save on costs 20 22–27. Accordingly, this protocol proposes the feasibility assessment of nurse-assisted eHealth intervention consisting of remote monitoring of blood pressure, weight and heart rate for patients with HF, temperature and weight for patients with CRC, as well as symptoms for both patient groups in collaboration with a NN.…”