Adherence, adaptation and acceptance of elderly chronic heart failure patients to receiving healthcare via telephone-monitoring

Eur J Heart Fail. 2007 Nov;9(11):1104-11. doi: 10.1016/j.ejheart.2007.07.018. Epub 2007 Oct 17.

Abstract

Background: Although the potential to reduce hospitalisation and mortality in chronic heart failure (CHF) is well reported, the feasibility of receiving healthcare by structured telephone support or telemonitoring is not.

Aims: To determine; adherence, adaptation and acceptability to a national nurse-coordinated telephone-monitoring CHF management strategy. The Chronic Heart Failure Assistance by Telephone Study (CHAT).

Methods: Triangulation of descriptive statistics, feedback surveys and qualitative analysis of clinical notes. Cohort comprised of standard care plus intervention (SC+I) participants who completed the first year of the study.

Results: 30 GPs (70% rural) randomised to SC+I recruited 79 eligible participants, of whom 60 (76%) completed the full 12 month follow-up period. During this time 3619 calls were made into the CHAT system (mean 45.81 SD+/-79.26, range 0-369), Overall there was an adherence to the study protocol of 65.8% (95% CI 0.54-0.75; p=0.001) however, of the 60 participants who completed the 12 month follow-up period the adherence was significantly higher at 92.3% (95% CI 0.82-0.97, p<or=0.001). Only 3% of this elderly group (mean age 74.7+/-9.3 years) were unable to learn or competently use the technology. Participants rated CHAT with a total acceptability rate of 76.45%.

Conclusion: This study shows that elderly CHF patients can adapt quickly, find telephone-monitoring an acceptable part of their healthcare routine, and are able to maintain good adherence for a least 12 months.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological*
  • Aged
  • Australia
  • Chi-Square Distribution
  • Chronic Disease
  • Female
  • Heart Failure / psychology
  • Heart Failure / therapy*
  • Humans
  • Male
  • Patient Acceptance of Health Care*
  • Patient Compliance*
  • Rural Population
  • Telephone*