Structured Home Monitoring System Improves Outcomes for Heart Failure Patients
If you have congestive heart failure (CHF), your doctor will want to monitor you closely after discharge from the hospital. However, many obstacles can present themselves, such facility lack of adequate resources and patient non-compliance with care, which can lead to worsening disease. A new study has found that remote home monitoring of patients can bridge the gap in care, leading to more positive outcomes.
Sally C. Inglis BHSc, of Baker IDI Heart and Diabetes Institute in Melbourne Australia, and colleagues reviewed 27 studies that involved over 9500 patients that received heart failure management support either through structured telephone support or telemonitoring with digital, broadband, satellite, wireless or Bluetooth transmission of physiologic data.
Patients with CHF need to carefully monitor vital signs such as heart rate, blood pressure, and weight. Sudden weight gain, for example, can be a sign that the patient is retaining fluid and a worsening of the heart failure.
Heart failure-related hospitalizations dropped with both approaches: an 8% reduction was seen with structured telephone support and a 9% reduction with telemonitoring. Patient adherence to the recommended treatment guidelines also improved from 65.8% to 98.5%. In addition, quality of life appeared to be significantly improved in six of the telephone support studies and in three of the telemonitoring studies.
Telephone-based remote monitoring or support is one approach that is recommended in treatment guidelines and may be a key to expanding access to more patients without significantly increasing resources. It may also be an affordable method to improve quality of care for those unwilling or unable to make frequent clinic visits due to financial, transportation, or disability constraints.
"The aim of these interventions is to improve patient outcomes," said Dr. Inglis. "Like many chronic health conditions, heart failure causes considerable impact on quality of life, as well as being the cause of frequent hospitalization and shortened life expectancy. By monitoring the condition of patients in their own home on a regular basis, it may be possible to identify when the patient’s condition is deteriorating."
Congestive heart failure, a condition in which the heart can no longer pump an adequate supply of blood to the rest of the body, is a chronic, long-term condition. Symptoms include shortness of breath, cough, swelling of the feet, ankles and abdomen, weight gain, irregular or rapid pulse, and fatigue. Failure to control the condition can lead to deadly irregular heart rhythms, pulmonary edema, and total heart failure.
Inglis SC, et al "Structured telephone support or telemonitoring programmes for patients with chronic heart failure" Cochrane Database of Syst Rev 2010; 8: CD007228.