BACKGROUND: Weight telemonitoring may be an effective way to improve patients' ability to manage heart failure and prevent unnecessary utilization of health services. However, the effectiveness of such interventions is dependent upon patient adherence. OBJECTIVE: The purpose of this study was to determine how adherence to weight telemonitoring changes in response to 2 types of events: hospital readmissions and emergency department visits. METHODS: The Better Effectiveness After Transition-Heart Failure trial examined the effectiveness of a remote telemonitoring intervention compared with usual care for patients discharged to home after hospitalization for decompensated heart failure. Participants were followed for 180 days and were instructed to transmit weight readings daily. We used Poisson regression to determine the within-person effects of events on subsequent adherence. RESULTS: A total of 625 events took place during the study period. Most of these events were rehospitalizations (78.7%). After controlling for the number of previous events and discharge to a skilled nursing facility, the rate for adherence decreased by nearly 20% in the 2 weeks after a hospitalization compared with the 2 weeks before (adjusted rate ratio, 0.81; 95% confidence interval: 0.77-0.86; P < .001). CONCLUSIONS: Experiencing a rehospitalization had the effect of diminishing adherence to daily weighing. Providers using telemonitoring to monitor decompensation and manage medications should take advantage of the potential "teachable moment" during hospitalization to reinforce the importance of adherence.
BACKGROUND: Weight telemonitoring may be an effective way to improve patients' ability to manage heart failure and prevent unnecessary utilization of health services. However, the effectiveness of such interventions is dependent upon patient adherence. OBJECTIVE: The purpose of this study was to determine how adherence to weight telemonitoring changes in response to 2 types of events: hospital readmissions and emergency department visits. METHODS: The Better Effectiveness After Transition-Heart Failure trial examined the effectiveness of a remote telemonitoring intervention compared with usual care for patients discharged to home after hospitalization for decompensated heart failure. Participants were followed for 180 days and were instructed to transmit weight readings daily. We used Poisson regression to determine the within-person effects of events on subsequent adherence. RESULTS: A total of 625 events took place during the study period. Most of these events were rehospitalizations (78.7%). After controlling for the number of previous events and discharge to a skilled nursing facility, the rate for adherence decreased by nearly 20% in the 2 weeks after a hospitalization compared with the 2 weeks before (adjusted rate ratio, 0.81; 95% confidence interval: 0.77-0.86; P < .001). CONCLUSIONS: Experiencing a rehospitalization had the effect of diminishing adherence to daily weighing. Providers using telemonitoring to monitor decompensation and manage medications should take advantage of the potential "teachable moment" during hospitalization to reinforce the importance of adherence.
Authors: Friedrich Koehler; Sebastian Winkler; Michael Schieber; Udo Sechtem; Karl Stangl; Michael Böhm; Herbert Boll; Simone S Kim; Kerstin Koehler; Stephanie Lücke; Marcus Honold; Peter Heinze; Thomas Schweizer; Martin Braecklein; Bridget-Anne Kirwan; Goetz Gelbrich; Stefan D Anker Journal: Eur J Heart Fail Date: 2010-12 Impact factor: 15.534
Authors: John G F Cleland; Amala A Louis; Alan S Rigby; Uwe Janssens; Aggie H M M Balk Journal: J Am Coll Cardiol Date: 2005-04-22 Impact factor: 24.094
Authors: Emily Seto; Kevin J Leonard; Joseph A Cafazzo; Jan Barnsley; Caterina Masino; Heather J Ross Journal: J Med Internet Res Date: 2012-02-16 Impact factor: 5.428
Authors: Daniel Scherr; Peter Kastner; Alexander Kollmann; Andreas Hallas; Johann Auer; Heinz Krappinger; Herwig Schuchlenz; Gerhard Stark; Wilhelm Grander; Gabriele Jakl; Guenter Schreier; Friedrich M Fruhwald Journal: J Med Internet Res Date: 2009-08-17 Impact factor: 5.428