Format

Send to:

Choose Destination
See comment in PubMed Commons below
JAMA Intern Med. 2016 Mar 1;176(3):310-8. doi: 10.1001/jamainternmed.2015.7712.

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.

Author information

  • 1Department of Medicine, University of California, Los Angeles2Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.
  • 2Department of Internal Medicine, University of California, Davis4Department of Pediatrics, University of California, Davis.
  • 3Department of Medicine, University of California, Los Angeles.
  • 4Office of Nursing Research and Development, Cedars-Sinai Medical Center, Los Angeles, California.
  • 5Department of Medicine, University of California, San Francisco.
  • 6Department of Resource and Outcomes Management, Cedars-Sinai Medical Center, Los Angeles, California.
  • 7Department of Medicine, University of California, Los Angeles8Department of Health Policy & Management, University of California, Los Angeles9RAND Health, RAND Corporation, Santa Monica, California.
  • 8Program in Nursing Science, University of California, Irvine.
  • 9School of Nursing, University of California, Davis.
  • 10Department of Family and Preventive Medicine, University of California, San Diego13Department of Family Medicine and Community Health, University of Miami, Miami, Florida.
  • 11Department of Medicine, University of California, San Diego.
  • 12Department of Medicine, University of California, Irvine.
  • 13Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California.
  • 14Division of Public Health & Community Dentistry, University of California, Los Angeles.
  • 15Department of Medicine, University of California, Los Angeles8Department of Health Policy & Management, University of California, Los Angeles.
  • 16Department of Internal Medicine, University of California, Davis.
  • 17Department of Computer Science, University of California, Los Angeles19Department of Electrical Engineering, University of California, Los Angeles.

Abstract

IMPORTANCE:

It remains unclear whether telemonitoring approaches provide benefits for patients with heart failure (HF) after hospitalization.

OBJECTIVE:

To evaluate the effectiveness of a care transition intervention using remote patient monitoring in reducing 180-day all-cause readmissions among a broad population of older adults hospitalized with HF.

DESIGN, SETTING, AND PARTICIPANTS:

We randomized 1437 patients hospitalized for HF between October 12, 2011, and September 30, 2013, to the intervention arm (715 patients) or to the usual care arm (722 patients) of the Better Effectiveness After Transition-Heart Failure (BEAT-HF) study and observed them for 180 days. The dates of our study analysis were March 30, 2014, to October 1, 2015. The setting was 6 academic medical centers in California. Participants were hospitalized individuals 50 years or older who received active treatment for decompensated HF.

INTERVENTIONS:

The intervention combined health coaching telephone calls and telemonitoring. Telemonitoring used electronic equipment that collected daily information about blood pressure, heart rate, symptoms, and weight. Centralized registered nurses conducted telemonitoring reviews, protocolized actions, and telephone calls.

MAIN OUTCOMES AND MEASURES:

The primary outcome was readmission for any cause within 180 days after discharge. Secondary outcomes were all-cause readmission within 30 days, all-cause mortality at 30 and 180 days, and quality of life at 30 and 180 days.

RESULTS:

Among 1437 participants, the median age was 73 years. Overall, 46.2% (664 of 1437) were female, and 22.0% (316 of 1437) were African American. The intervention and usual care groups did not differ significantly in readmissions for any cause 180 days after discharge, which occurred in 50.8% (363 of 715) and 49.2% (355 of 722) of patients, respectively (adjusted hazard ratio, 1.03; 95% CI, 0.88-1.20; P = .74). In secondary analyses, there were no significant differences in 30-day readmission or 180-day mortality, but there was a significant difference in 180-day quality of life between the intervention and usual care groups. No adverse events were reported.

CONCLUSIONS AND RELEVANCE:

Among patients hospitalized for HF, combined health coaching telephone calls and telemonitoring did not reduce 180-day readmissions.

TRIAL REGISTRATION:

clinicaltrials.gov Identifier: NCT01360203.

PMID:
26857383
[PubMed - in process]
PMCID:
PMC4827701
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Silverchair Information Systems Icon for PubMed Central
    Loading ...
    Write to the Help Desk