Use of a community-based participatory research model helped refine a telemonitoring program for low-income, black and Hispanic heart failure patients, according to research published in BMC Medical Informatics and Decision Making.
This was an initial phase in a larger clinical trial to compare telemonitoring with usual care for heart failure. The researchers, from Hofstra Northwell School of Medicine in New York, however, wanted to create a telemonitoring program that was acceptable and feasible for this population.
The study included two focus groups with key stakeholders, including patients and nonprofessional caregivers, patient advocates, cultural experts, a geriatrician, a heart failure expert, a nurse and a pharmacist. A third focus group consisted of patients only; greater weight was given to their input.
The telemonitoring included daily vital sign monitoring in both English and Spanish, transmitted wirelessly to a provider station, and a weekly face-to-face video visit with a clinician that involved listening to patients' heart and lung sounds through a stethoscope.
The researchers found that in this population, heart failure can affect younger patients, that patients tend to have more co-morbid health conditions and that scheduling of appointments and transportation often poses a significant barrier to care. They received suggestions to improve usability of the equipment, and also heard concerns about the accuracy of Spanish translation, font size in printed instructions and medical jargon. They found that more practice with the equipment helped to improve patients' comfort levels, and that the use of both printed and audio instructions helped, as did simplification of the reading level. Meeting the nurse in person initially helped them connect with a friendly face.
The researchers also found that patients needed to be reassured that telemonitoring did not replace their normal doctor visits and that their immigration status had no bearing on treatment and would be kept confidential.
To learn more:
- here's the research