Abstract 4356: Remote Monitoring Program may Improve Outcomes for Heart Failure Patients
Background: A previous study demonstrated that remote monitoring (RM) of homebound heart failure (HF) patients reduced hospital readmissions by 25%. Little is known about whether a HF-management program involving RM may also benefit non-homebound patients. We hypothesized that enrolling ambulatory HF patients into a daily RM program would improve outcomes through behavior change and timely intervention.
Objective: The primary outcome measure for the study was all-cause readmissions. Secondary endpoints including HF-related readmissions, mortality, ER visits and length of stay were compared between patients who participated in a RM program and patients who either declined or were not offered the opportunity to participate.
Methods: Eligible patients from Massachusetts General Hospital (n =150) were randomly assigned to usual care (n =68, mean age=70±1.7 years) or RM. Of 82 people offered RM support, 40 declined to participate (non-participants; mean age 68±2.3 years) and 42 agreed (participants; mean age =65 ±2.2 years). The participants transmitted daily vital signs data and weight to a nurse who coordinated care with the physician. Timely interventions and teaching were offered over the course of the 6 month study. Per protocol and intention to treat approaches were used to analyze the data.
Results: The study verified a trend, previously seen in the 3-month analysis, that participants in the RM program had a lower all cause per person readmission (mean=0.64, SD±0.87) compared with usual care group (mean =0.73, SD±1.51) and non-participants (mean=0.75, SD±1.05) although this did not approach statistical significance. Participants had 50% lower HF-related readmissions (mean=0.19 SD±0.45) compared to the usual care group (mean=0.38, SD±1.06). There were no significant differences in ER visits, mortality or length of stay in the three groups. We believe a larger randomized trial is required to definitively conclude on the benefits of RM. Post-study surveys received from participants reveal high level (93%) of satisfaction.
Conclusions: This study extends the use of RM to ambulatory HF patients. Our pilot shows that RM may have the potential to reduce both all cause and HF-related readmissions and lead to high level of patient satisfaction.