Resource Use in Veterans With Congestive Heart Failure Following a Home Telehealth Intervention

2.50
Hdl Handle:
http://hdl.handle.net/10755/158548
Type:
Presentation
Title:
Resource Use in Veterans With Congestive Heart Failure Following a Home Telehealth Intervention
Abstract:
Resource Use in Veterans With Congestive Heart Failure Following a Home Telehealth Intervention
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2007
Author:Wakefield, Bonnie
P.I. Institution Name:Harry S. Truman Memorial Veterans Hospital
Contact Address:Research Service, 800 Hospital Drive, Columbia, MO, 65201, USA
Co-Authors:M.M. Ward, J. Holman, A. Ray, S. Melody, and G.E. Rosenthal, Center for Implementation of Innovative Strategies in Practice (CRIISP), Iowa City VA Medical Center, Iowa City, IA; and M. Kienzle, Carver College of Medicine, The University of Iowa, Iowa City
Congestive heart failure (CHF) is one of the most common reasons for hospitalization in older patients, and frequent admissions are common. Advanced telehealth technologies make it possible to detect early signs of decompensation but few empirical studies have compared telehealth to traditional outpatient care, and virtually no studies have compared the effectiveness of alternative telehealth applications. The purpose of this study was to compare the effectiveness of two telehealth interventions to traditional care provided for recently discharged outpatients with CHF. Using a randomized controlled clinical trial, we compared usual care to a nurse managed intervention delivered by either telephone or videophone to veterans following discharge from the hospital. Subjects in the treatment groups received the intervention for 90 days following discharge; subjects in the usual care group received traditional outpatient care. All 104 patients were male; 97% were white. Average age at enrollment was 69.5 years. Severity of illness at enrollment was comparable across the three groups. Preliminary analyses show no significant differences across the three groups in 90 day readmission rates. A one-way analysis of variance (ANOVA) showed significant differences in 180 day readmission rates across the three groups (F=0.0263); post hoc analyses showed significantly higher (p </= 0.05) readmission rates in the videophone (mean =0.85 +/- 0.87) compared to either the telephone (mean=0.28 +/- 0.58) or usual care group (mean=0.64 +/- 0.99). There were no significant differences across the three groups in Urgent Care Clinic visits. While 6-month mortality was higher in the videophone (21%) compared to the telephone (12%) and usual care (13%) group, this was not statistically significant. Although the nurse intervention was identical in the telephone and videophone groups, the telephone intervention only was effective in reducing 180-day readmission rates. Neither intervention was effective in reducing 90-day readmissions or mortality compared to the usual care group. Further work is needed to determine which technologies work for specific patient populations. Funded by VA HSR&D NRI 99-345-1
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleResource Use in Veterans With Congestive Heart Failure Following a Home Telehealth Interventionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158548-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Resource Use in Veterans With Congestive Heart Failure Following a Home Telehealth Intervention</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Wakefield, Bonnie</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Harry S. Truman Memorial Veterans Hospital</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Research Service, 800 Hospital Drive, Columbia, MO, 65201, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">bonnie.wakefield@va.gov</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">M.M. Ward, J. Holman, A. Ray, S. Melody, and G.E. Rosenthal, Center for Implementation of Innovative Strategies in Practice (CRIISP), Iowa City VA Medical Center, Iowa City, IA; and M. Kienzle, Carver College of Medicine, The University of Iowa, Iowa City</td></tr><tr><td colspan="2" class="item-abstract">Congestive heart failure (CHF) is one of the most common reasons for hospitalization in older patients, and frequent admissions are common. Advanced telehealth technologies make it possible to detect early signs of decompensation but few empirical studies have compared telehealth to traditional outpatient care, and virtually no studies have compared the effectiveness of alternative telehealth applications. The purpose of this study was to compare the effectiveness of two telehealth interventions to traditional care provided for recently discharged outpatients with CHF. Using a randomized controlled clinical trial, we compared usual care to a nurse managed intervention delivered by either telephone or videophone to veterans following discharge from the hospital. Subjects in the treatment groups received the intervention for 90 days following discharge; subjects in the usual care group received traditional outpatient care. All 104 patients were male; 97% were white. Average age at enrollment was 69.5 years. Severity of illness at enrollment was comparable across the three groups. Preliminary analyses show no significant differences across the three groups in 90 day readmission rates. A one-way analysis of variance (ANOVA) showed significant differences in 180 day readmission rates across the three groups (F=0.0263); post hoc analyses showed significantly higher (p &lt;/= 0.05) readmission rates in the videophone (mean =0.85 +/- 0.87) compared to either the telephone (mean=0.28 +/- 0.58) or usual care group (mean=0.64 +/- 0.99). There were no significant differences across the three groups in Urgent Care Clinic visits. While 6-month mortality was higher in the videophone (21%) compared to the telephone (12%) and usual care (13%) group, this was not statistically significant. Although the nurse intervention was identical in the telephone and videophone groups, the telephone intervention only was effective in reducing 180-day readmission rates. Neither intervention was effective in reducing 90-day readmissions or mortality compared to the usual care group. Further work is needed to determine which technologies work for specific patient populations. Funded by VA HSR&amp;D NRI 99-345-1</td></tr></table>en_GB
dc.date.available2011-10-26T21:09:57Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:09:57Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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