Abstract 17488: Impact of the Connected Cardiac Care Program on Hospitalizations and Mortality: a Matched-control Analysis
Connected Cardiac Care program(CCCP)is a 4-month home telemonitoring and education program designed to improve self-management in patients with heart failure. Participants monitor relevant physiologic parameters everyday,answer symptom-based questions on a touch-screen computer and also receive structured weekly education sessions via telephone. The parameters are reviewed by telemonitoring nurses who provide “just-in time” teaching when they are out of range. This study aims to evaluate the effect of CCCP on hospitalization and mortality in a retrospective database review of medical records of patients with heart failure receiving care at the Massachusetts General Hospital.
Methods: Three hundred and eighteen CCCP patients were matched with controls identified from the Research Patient Data Repository - a clinical data registry that gathers medical records from various Partners Healthcare-affiliated hospitals and stores them in a central location. A control was identified for each CCCP participant by selecting a control was hospitalized within 30 days of the corresponding CCCP patient’s index hospitalization before enrollment in the CCCP. Other matching parameter are age,race and gender. All-cause hospitalization and mortality records were collected and reviewed for over a period of 1 year starting from the date of enrollment into CCCP. Outcomes were assessed at months 1,2,3,4 and at the end of the 1 year review period. Cumulative survival curves for time-to-event analyses were constructed by the Kaplan-Meier method with differences in curves examined by the log-rank statistic and hazard ratios estimated by the Mantel-Cox method.
Results: At months 1,2,3 and 4, CCCP decreased hospitalization by 51% (P<0.001), 26% (P=0.03), 17% (P=0.12) and 4% (P=0.74) respectively. Similarly, mortality decreased in CCCP patients by 82% (P=0.01), 77% (P<0.001), 71% (P<0.001) and 71% (P<0.001). However, over the 1-year follow-up, all-cause hospitalization increased by 38% (P< 0.001) in CCCP patients while all-cause mortality reduced by 48% (P <0.01).
Conclusion: CCCP significantly reduced mortality at 1-year follow-up and reduced hospitalizations within 4 months of CCCP admission but was associated with increased hospitalizations at the end of one year.
- © 2013 by American Heart Association, Inc.