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Managing Heart Failure Patients After Formal Homecare

Telemedicine and e-Health. December 2009, 15(10): 983-991. doi:10.1089/tmj.2009.0064. Kathryn Dansky, Ph.D., and Joseph Vasey, Ph.D. Department of Health Policy and Administration, Pennsylvania State University, University Park, Pennsylvania

The aim of this study was to determine whether using a teleheath system after discharge from formal home health services would improve clinical outcomes and self-management behaviors.

Patients were recruited from 10 home health agencies (HHAs) across the United States. All patients used the Health Buddy telehealth system during formal home health services. Patients were randomly assigned to either the telehealth group or the control group upon discharge from the HHA. Patients in the telehealth group used the Health Buddy for an additional 180 days; patients in the control group received no further telehealth or home health services.

Results show that patients who continued using telehealth beyond the formal episode of care showed greater improvements in respiratory status and activities of daily living. None of the patients who used telehealth during this stage had any hospitalizations or Emergency Department (ED) events, while 28.3% of the control group patients required hospitalization and 26.1% had at least one ED visit. Telehealth patients were more likely to report that they measured their weights daily, and were more likely to report an increase in diuretic dose following sudden weight gain, ankle swelling, or shortness of breath.

We conclude that patients with heart failure may benefit from continued use of telehealth following formal home health services. Results of this study will inform managers and clinicians who are responsible for integrating telehealth into chronic disease protocols.

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