Study: Patient Outcomes Decline After Remote Monitoring Ends
April 24, 2015 in News
While a remote monitoring program helped to reduce hospitalizations and mortality among patients with congestive heart failure, hospitalization rates increased when the program ended, according to a study published Wednesday in the Journal of Medical Internet Research, MobiHealthNews reports.
The study looked at 348 congestive heart failure patients at Partners HealthCare’s Boston-area hospitals. Researchers used data from electronic health records to match 174 control patients with 174 patients signed up for the Connected Cardiac Care Program.
The program lasted for 120 days, during which patients in CCCP used connected devices that monitored:
- Blood oxygen saturation;
- Blood pressure;
- Heart rate; and
In addition, CCCP patients:
- Answered questions about symptoms related to heart failure daily via a touch-screen computer that sent the data to nurses who contacted patients if there were unusual readings; and
- Received biweekly educational sessions over the phone on topics ranging from correct monitoring to diet and exercise.
During the 120-day program, hospitalization and mortality rates decreased for CCCP patients. However, once the patients were no longer monitored remotely, hospitalization rates increased.
Specifically, the study found:
- After 30 days, 24 CCCP patients had been hospitalized, compared with 49 in the control group;
- After 60 days, 43 CCCP patients had been hospitalized, compared with 68 in the control group;
- After 120 days, 75 CCCP patients had been hospitalized, compared with 97 in the control group; and
- After 120 days, five CCCP patients had died, compared with 12 in the control group.
In addition, the study found that eight months after the monitoring program ended, the CCCP group had more hospitalizations than the control group. Specifically, 180 hospitalizations occurred in the CCCP group, compared with 151 in the control group. The CCCP group’s mortality rate remained lower than the control group’s at that time.
The study authors noted that various factors could have contributed to the CCCP group’s higher hospitalization rate, such as:
- The CCCP patients became more sensitive to the disease’s early warning signs because of the educational programs they received;
- The CCCP patients could have failed to develop self-management skills because they received close attention during the study period; and
- More control group patients dying earlier than CCCP patients.
Partners HealthCare is considering revising the program to place a greater emphasis on learning to self-manage disease to better prepare patients for when the program ends (Comstock, MobiHealthNews, 4/23).