A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: study protocol for the Better Effectiveness After Transition - Heart Failure BEAT-HF randomized controlled triReportar como inadecuado




A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: study protocol for the Better Effectiveness After Transition - Heart Failure BEAT-HF randomized controlled tri - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Trials

, 15:124

First Online: 13 April 2014Received: 29 September 2013Accepted: 19 March 2014DOI: 10.1186-1745-6215-15-124

Cite this article as: Black, J.T., Romano, P.S., Sadeghi, B. et al. Trials 2014 15: 124. doi:10.1186-1745-6215-15-124

Abstract

BackgroundHeart failure is a prevalent health problem associated with costly hospital readmissions. Transitional care programs have been shown to reduce readmissions but are costly to implement. Evidence regarding the effectiveness of telemonitoring in managing the care of this chronic condition is mixed. The objective of this randomized controlled comparative effectiveness study is to evaluate the effectiveness of a care transition intervention that includes pre-discharge education about heart failure and post-discharge telephone nurse coaching combined with home telemonitoring of weight, blood pressure, heart rate, and symptoms in reducing all-cause 180-day hospital readmissions for older adults hospitalized with heart failure.

Methods-DesignA multi-center, randomized controlled trial is being conducted at six academic health systems in California. A total of 1,500 patients aged 50 years and older will be enrolled during a hospitalization for treatment of heart failure. Patients in the intervention group will receive intensive patient education using the ‘teach-back’ method and receive instruction in using the telemonitoring equipment. Following hospital discharge, they will receive a series of nine scheduled health coaching telephone calls over 6 months from nurses located in a centralized call center. The nurses also will call patients and patients’ physicians in response to alerts generated by the telemonitoring system, based on predetermined parameters. The primary outcome is readmission for any cause within 180 days. Secondary outcomes include 30-day readmission, mortality, hospital days, emergency department ED visits, hospital cost, and health-related quality of life.

DiscussionBEAT-HF is one of the largest randomized controlled trials of telemonitoring in patients with heart failure, and the first explicitly to adapt the care transition approach and combine it with remote telemonitoring. The study population also includes patients with a wide range of demographic and socioeconomic characteristics. Once completed, the study will be a rich resource of information on how best to use remote technology in the care management of patients with chronic heart failure.

Trial registrationClinicalTrials.gov # NCT01360203.

KeywordsHeart failure Telemonitoring Nurse coaching Readmission Care coordination Self-care Electronic supplementary materialThe online version of this article doi:10.1186-1745-6215-15-124 contains supplementary material, which is available to authorized users.

Download fulltext PDF



Autor: Jeanne T Black - Patrick S Romano - Banafsheh Sadeghi - Andrew D Auerbach - Theodore G Ganiats - Sheldon Greenfield - Sh

Fuente: https://link.springer.com/







Documentos relacionados