Institutional members access full text with Ovid®

Examining the Effects of Remote Monitoring Systems on Activation, Self-care, and Quality of Life in Older Patients With Chronic Heart Failure

Evangelista, Lorraine S. PhD, RN, FAHA, FAAN; Lee, Jung-Ah PhD, RN; Moore, Alison A. MD, MPH; Motie, Marjan PhD; Ghasemzadeh, Hassan PhD; Sarrafzadeh, Majid PhD; Mangione, Carol M. MD, MSPH

doi: 10.1097/JCN.0000000000000110
Articles

Background: The use of remote monitoring systems (RMSs) in healthcare has grown exponentially and has improved the accessibility to and ability of patients to engage in treatment intensification. However, research describing the effects of RMSs on activation, self-care, and quality of life (QOL) in older patients with heart failure (HF) is limited.

Objective: The aim of this study was to compare the effects of a 3-month RMS intervention on activation, self-care, and QOL of older patients versus a reference group matched on age, gender, race, and functional status (ie, New York Heart Association classification) who received standard discharge instructions after an acute episode of HF exacerbation requiring hospitalization.

Methods: A total of 21 patients (mean age, 72.7 ± 8.9 years; range, 58–83 years; 52.4% women) provided consent and were trained to measure their weight, blood pressure, and heart rate at home with an RMS device and transmit this information every day for 3 months to a centralized information system. The system gathered all data and dispatched alerts when certain clinical conditions were met.

Results: The baseline sociodemographic and clinical characteristics of the 2 groups were comparable. Over time, participants in the RMS group showed greater improvements in activation, self-care, and QOL compared with their counterparts. Data showed moderately strong associations between increased activation, self-care, and QOL.

Conclusion: Our preliminary data show that the use of an RMS is feasible and effective in promoting activation, self-care, and QOL. A larger-scale randomized clinical trial is warranted to show that the RMS is a new and effective method for improving clinical management of older adults with chronic HF.

Lorraine S. Evangelista, PhD, RN, FAHA, FAAN Associate Professor, Program of Nursing Science, University of California Irvine.

Jung-Ah Lee, PhD, RN Assistant Professor, Program of Nursing Science, University of California Irvine.

Alison A. Moore, MD, MPH Professor of Medicine and Psychiatry, David Geffen School of Medicine, University of California, Los Angeles.

Marjan Motie, PhD Project Director, Pro-HEART, Program of Nursing Science, University of California Irvine.

Hassan Ghasemzadeh, PhD Research Manager, Computer Science Department, University of California, Los Angeles.

Majid Sarrafzadeh, PhD Professor, Computer Science Department, & Director, UCLA Wireless Health Institute, University of California, Los Angeles.

Carol M. Mangione, MD, MSPH Program Director, Resource Center for Minority Aging Research, Center for Health Improvement of Minority Elderly (RCMAR/CHIME), Los Angeles, California.

Funding was received from the National Heart, Lung, and Blood Institute (1R01HL093466-01) and University of California, Los Angeles, Resource Centers for Minority Aging Research/Center for Health Improvement of Minority Elderly, under National Institute in Aging (P30-AG02-1684; principal investigator, C. Mangione).

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute–National Institutes of Health or the National Institute on Aging.

The authors have no conflicts of interest to disclose.

Correspondence Lorraine S. Evangelista, PhD, RN, FAHA, FAAN, Program of Nursing Science, University of California Irvine, Irvine, CA 92697 (l.evangelista@uci.edu).

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved