Adherence, adaptation and acceptance of elderly chronic heart failure patients to receiving healthcare via telemonitoring

  • Dr Robyn Clark, Sansom Institute, University of South Australia. On behalf of the CHAT Study Project Team., Australia
  • Dr Julie Yallop, Department of Epidemiology and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University,, Australia
  • Prof Leon Piterman, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, East Bentleigh, Victoria, Australia
  • Prof Andrew Tonkin, Department of Epidemiology and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
  • Prof Simon Stewart, Baker IDI, Australia
  • Prof Henry Krum, Department of Epidemiology and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University., Australia

Purpose: Evaluation of the feasibility of receiving healthcare by telephone or telemonitoring in chronic heart failure.
Aims: To determine; adherence, adaptation and acceptability to a national nurse-coordinated telemonitoring strategy.
Methods: Triangulation of demographics and call patterns with feedback surveys and qualitative analysis of clinical notes of the participants who completed the first year of the study.
Results: 30 GPs (70% rural) cluster randomised to SC+I, recruited 79 eligible participants, of which 63 (75.9%) completed the full 12 month follow-up period of this study. During this time 3619 calls were made into the CHAT system (mean 45.81 SD ±79.26, range 0-369), Overall there was an adherence level to the study protocol of 65.8% (95% CI 0.54-0.75; p=0.001) however, within the group 60 participants who completed the first 12 month follow-up period the adherence rate was significantly higher at 92.3% (95% CI 0.82-0.97, p≤ 0.001).
In addition a total of 1463 outgoing calls were made by the specialist cardiac nurses. The themes for these calls included heart failure management 73% (weight, fluid, diet, medicine management, hospitalisation, social /depression) and technical failure / reminder calls (27%).
Only 3% of this elderly group (mean age 74.7 ±9.3) were unable to learn or competently use the technology. Participants rated the CHAT project with a total acceptability (satisfaction) rate of 76.45%.
Conclusion: This study has shown that elderly CHF patients can adapt quickly, find the use of telemonitoring an acceptable part of their healthcare routine, and are able to maintain good adherence for a least 12 months.