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Association Between Participation in a Heart Failure Telemonitoring Program and Health Care Utilization and Death Within an Integrated Health Care Delivery System.
Parikh, Rishi V; Axelrod, Amir W; Ambrosy, Andrew P; Tan, Thida C; Bhatt, Ankeet S; Fitzpatrick, Jesse K; Lee, Keane K; Adatya, Sirtaz; Vasadia, Jitesh V; Dinh, Howard H; Go, Alan S.
Afiliación
  • Parikh RV; Division of Research, Kaiser Permanente Northern California, Oakland, California; Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, California.
  • Axelrod AW; Department of Cardiology, Kaiser Permanente Vallejo Medical Center, Vallejo, California.
  • Ambrosy AP; Division of Research, Kaiser Permanente Northern California, Oakland, California; Department of Cardiology, Kaiser Permanente San Francisco Medical Center, San Francisco, California.
  • Tan TC; Division of Research, Kaiser Permanente Northern California, Oakland, California.
  • Bhatt AS; Division of Research, Kaiser Permanente Northern California, Oakland, California; Department of Cardiology, Kaiser Permanente San Francisco Medical Center, San Francisco, California.
  • Fitzpatrick JK; Department of Cardiology, Kaiser Permanente Santa Clara Medical Center, Santa Clara, California.
  • Lee KK; Department of Cardiology, Kaiser Permanente Santa Clara Medical Center, Santa Clara, California.
  • Adatya S; Department of Cardiology, Kaiser Permanente Santa Clara Medical Center, Santa Clara, California.
  • Vasadia JV; Department of Cardiology, Kaiser Permanente Santa Rosa Medical Center, Santa Rosa, California.
  • Dinh HH; Department of Cardiology, Kaiser Permanente South Sacramento Medical Center, Sacramento, California.
  • Go AS; Division of Research, Kaiser Permanente Northern California, Oakland, California; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California; Departments of Epidemiology, Biostatistics and Medicine, University of California, San Francisco, Calif
J Card Fail ; 29(12): 1642-1654, 2023 12.
Article en En | MEDLINE | ID: mdl-37220825
BACKGROUND: The clinical usefulness of remote telemonitoring to reduce postdischarge health care use and death in adults with heart failure (HF) remains controversial. METHODS AND RESULTS: Within a large integrated health care delivery system, we matched patients enrolled in a postdischarge telemonitoring intervention from 2015 to 2019 to patients not receiving telemonitoring at up to a 1:4 ratio on age, sex, and calipers of a propensity score. Primary outcomes were readmissions for worsening HF and all-cause death within 30, 90, and 365 days of the index discharge; secondary outcomes were all-cause readmissions and any outpatient diuretic dose adjustments. We matched 726 patients receiving telemonitoring to 1985 controls not receiving telemonitoring, with a mean age of 75 ± 11 years and 45% female. Patients receiving telemonitoring did not have a significant reduction in worsening HF hospitalizations (adjusted rate ratio [aRR] 0.95, 95% confidence interval [CI] 0.68-1.33), all-cause death (adjusted hazard ratio 0.60, 95% CI 0.33-1.08), or all-cause hospitalization (aRR 0.82, 95% CI 0.65-1.05) at 30 days, but did have an increase in outpatient diuretic dose adjustments (aRR 1.84, 95% CI 1.44-2.36). All associations were similar at 90 and 365 days postdischarge. CONCLUSIONS: A postdischarge HF telemonitoring intervention was associated with more diuretic dose adjustments but was not significantly associated with HF-related morbidity and mortality.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Telemedicina / Insuficiencia Cardíaca Tipo de estudio: Risk_factors_studies Aspecto: Implementation_research Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Card Fail Asunto de la revista: CARDIOLOGIA Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Telemedicina / Insuficiencia Cardíaca Tipo de estudio: Risk_factors_studies Aspecto: Implementation_research Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Card Fail Asunto de la revista: CARDIOLOGIA Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos