Lack of adherence sinks UCLA remote monitoring study

Telemonitoring failed to improve readmission rates for heart failure patients in research from the University of California-Los Angeles.

A major problem was that 43 percent of patients dropped out of the study.

"There are individuals who do seem to benefit from these type of approaches, and then identifying [those who will adhere] to these interventions is probably the key issue in terms of use of these type of devices," lead author Michael K. Ong, M.D., told MedPage Today.

The study, known as BEAT-HF, aimed to catch problems early before they led to readmission. After discharge, patients were directed to measure and transmit their weight, blood pressure, heart rate and whether they were taking their medications. They used a Bluetooth-enabled digital scale and automated blood pressure machine with texting capabilities to transmit the data via a cellular transmitter to a central call center at UCLA. They also received regularly scheduled phone calls with a registered nurse, explains an article from the American Heart Association.

Telemonitoring did not improve rates of hospital readmissions within 30 or 180 days compared with a  group receiving regular care. There were fewer deaths in the telemonitoring group at 30 days, but Ong did not attribute that to telemonitoring. The intervention did not lower deaths within 180 days.

Patients in the study used BlackBerry mobile phones. Ong said that newer wearable devices like the Fitbit or Apple Watch are less obtrusive and show promise for monitoring heart failure patients in the future.

A Mayo Clinic research team previously scrutinized 51 studies comparing digital tools with usual care in recurrence of cardiovascular incidents. They determined that digital technology-- the most effective being text messaging, Web portals and telemedicine--reduced secondary adverse medical issues by 40 percent.

Penn Medicine also says use of an app and a tablet cut readmission rates for heart failure patients by 53 percent.

To learn more:
- find the research
- read the MedPage Today article
- check out the Heart Association piece

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