Testing the Effects of Telehealth Monitoring on Rehospitalization and Self Care for Heart Failure Patients in Home Care
| Status: | Completed |
|---|---|
| Conditions: | Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 55 - Any |
| Updated: | 4/21/2016 |
| Start Date: | September 2005 |
| End Date: | June 2010 |
Promoting Self Care Using Telehomecare: Impact on Outcomes
We are testing the use of telehealth technology that includes self monitoring of blood
pressure, weight, blood sugar, and oxygen levels for patients with heart failure who are
receiving home care. We are interested to learn if using the equipment results in improved
self care and decreased incidence of rehospitalization.
pressure, weight, blood sugar, and oxygen levels for patients with heart failure who are
receiving home care. We are interested to learn if using the equipment results in improved
self care and decreased incidence of rehospitalization.
Despite telehomecare's potential to enhance patients' self-care in a cost-effective manner,
few studies have evaluated its efficacy. Reported studies were conducted prior to the
introduction of Medicare's prospective payment system for home care and evaluated the use of
telehomecare in addition to traditional home visits. None examined patients' involvement in
decision-making regarding the use of such technology in meeting their health care needs.
Available data suggest that telehomecare may improve self-care and enhance outcomes for
elders with heart failure but major gaps in knowledge exist regarding the clinical and cost
effectiveness of this technology when decisions regarding its use are negotiated with
patients and when it substitutes for traditional nurse visits under the recently introduced
changes in the financing of home health care.
Patient and cost outcomes will include: self-care, health care resource utilization, health
status, quality of life, satisfaction, access to care and cost effectiveness. Data analysis
will consist of a variety of statistical tests, and estimates of treatment costs. Findings
will help guide optimal use of telehomecare in promoting self-care in the growing population
of chronically ill elders whose conditions are characterized by high morbidity, complex
therapies and poor quality and cost outcomes.
Subjects will be enrolled from the acute care setting and will be randomized to receive home
care with or without telehealth monitoring. Baseline and follow-up interviews will be
conducted at admission, 60, 120 and 180 days.
few studies have evaluated its efficacy. Reported studies were conducted prior to the
introduction of Medicare's prospective payment system for home care and evaluated the use of
telehomecare in addition to traditional home visits. None examined patients' involvement in
decision-making regarding the use of such technology in meeting their health care needs.
Available data suggest that telehomecare may improve self-care and enhance outcomes for
elders with heart failure but major gaps in knowledge exist regarding the clinical and cost
effectiveness of this technology when decisions regarding its use are negotiated with
patients and when it substitutes for traditional nurse visits under the recently introduced
changes in the financing of home health care.
Patient and cost outcomes will include: self-care, health care resource utilization, health
status, quality of life, satisfaction, access to care and cost effectiveness. Data analysis
will consist of a variety of statistical tests, and estimates of treatment costs. Findings
will help guide optimal use of telehomecare in promoting self-care in the growing population
of chronically ill elders whose conditions are characterized by high morbidity, complex
therapies and poor quality and cost outcomes.
Subjects will be enrolled from the acute care setting and will be randomized to receive home
care with or without telehealth monitoring. Baseline and follow-up interviews will be
conducted at admission, 60, 120 and 180 days.
Inclusion Criteria:
- Primary diagnosis of heart failure, English speaking; mentally competent, weigh less
than 450 pounds, have a telephone in their home; have Medicare insurance; are able to
see, hear, place a cuff on their arm, and stand on a scale to weigh themselves,
receiving home care from Penn Care at Home.
Exclusion Criteria:
- cognitive impairment, weight > 450 pounds, receiving disease management or on a heart
transplant waiting list, receiving home care from a non- participating agency.
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