Jenice Guzman-Clark1, Melissa M Farmer2, Bonnie J Wakefield3, Benjamin Viernes4, Maria Yefimova5, Martin L Lee6, Theodore J Hahn7. 1. VA Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, North Hills, CA; Southern Arizona VA Healthcare System, Tucson, AZ. Electronic address: JeniceRia.Guzman@va.gov. 2. VA Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, North Hills, CA. 3. VA Center for Comprehensive Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IA; University of Missouri Sinclair School of Nursing, S235 School of Nursing University of Missouri, Columbia, MO. 4. VA Salt Lake City Health Care System, Salt Lake City, UT; University of Utah School of Medicine, Salt Lake City, UT. 5. UCLA/VA National Clinician Scholar, Los Angeles, CA. 6. VA Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, North Hills, CA; UCLA Fielding School of Public Health, Los Angeles, CA. 7. VA Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, North Hills, CA; UCLA School of Medicine, Los Angeles, CA; VA Geriatric Research, Education & Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA.
Abstract
BACKGROUND: Daily use of home telehealth (HT) technologies decreases over time. Barriers to continued use are unclear. PURPOSE: To examine predictors of drop-out from HT in Veterans with heart failure. METHODS: Data for Veterans with heart failure enrolled in the Veterans Affairs HT Program were analyzed using a mixed effects Cox regression model to determine risk of dropping-out over a 1-year period. FINDINGS: Older (hazard ratio [HR] 1.01), sicker (prior hospital readmission [HR 1.39]), higher probability of hospital admission/death [HR 1.23], functional impairments [1.14]) and white Veterans (compared to black; HR 1.41) had higher risk of drop-out in HT Programs. Users of VA's online patient portal (HR 0.90) had lower risk of drop-out. DISCUSSION: Older and sicker patients are at most risk of stopping HT use, yet use of a patient portal shows promise in improving continued use. Interventions targeting patients at high risk for HT discontinuation are needed to promote ongoing engagement. Published by Elsevier Inc.
BACKGROUND: Daily use of home telehealth (HT) technologies decreases over time. Barriers to continued use are unclear. PURPOSE: To examine predictors of drop-out from HT in Veterans with heart failure. METHODS: Data for Veterans with heart failure enrolled in the Veterans Affairs HT Program were analyzed using a mixed effects Cox regression model to determine risk of dropping-out over a 1-year period. FINDINGS: Older (hazard ratio [HR] 1.01), sicker (prior hospital readmission [HR 1.39]), higher probability of hospital admission/death [HR 1.23], functional impairments [1.14]) and white Veterans (compared to black; HR 1.41) had higher risk of drop-out in HT Programs. Users of VA's online patient portal (HR 0.90) had lower risk of drop-out. DISCUSSION: Older and sicker patients are at most risk of stopping HT use, yet use of a patient portal shows promise in improving continued use. Interventions targeting patients at high risk for HT discontinuation are needed to promote ongoing engagement. Published by Elsevier Inc.
Entities:
Keywords:
Drop-out; Heart failure; Home telehealth; Remote patient monitoring; Veterans
Authors: Carolyn L Turvey; Donna M Zulman; Kim M Nazi; Bonnie J Wakefield; Susan S Woods; Timothy P Hogan; Frances M Weaver; Keith McInnes Journal: Telemed J E Health Date: 2012-02-03 Impact factor: 3.536
Authors: Michael K Ong; Patrick S Romano; Sarah Edgington; Harriet U Aronow; Andrew D Auerbach; Jeanne T Black; Teresa De Marco; Jose J Escarce; Lorraine S Evangelista; Barbara Hanna; Theodore G Ganiats; Barry H Greenberg; Sheldon Greenfield; Sherrie H Kaplan; Asher Kimchi; Honghu Liu; Dawn Lombardo; Carol M Mangione; Bahman Sadeghi; Banafsheh Sadeghi; Majid Sarrafzadeh; Kathleen Tong; Gregg C Fonarow Journal: JAMA Intern Med Date: 2016-03 Impact factor: 21.873
Authors: Marilyn Luptak; Nancy Dailey; Meghan Juretic; Randall Rupper; Robert D Hill; Bret L Hicken; Byron D Bair Journal: Rural Remote Health Date: 2010-06-01 Impact factor: 1.759
Authors: Peter J Kaboli; Jorge T Go; Jason Hockenberry; Justin M Glasgow; Skyler R Johnson; Gary E Rosenthal; Michael P Jones; Mary Vaughan-Sarrazin Journal: Ann Intern Med Date: 2012-12-18 Impact factor: 25.391
Authors: Kristen E Gray; Mayuree Rao; Eric Gunnink; Lee Eschenroeder; John R Geyer; Karin M Nelson; Ashok Reddy Journal: J Gen Intern Med Date: 2022-03-01 Impact factor: 6.473