The BEAT-HF study is an ongoing randomized controlled trial designed to evaluate whether a care transition intervention combining pre-discharge education, telephone nurse coaching, and home telemonitoring reduces 180-day all-cause readmissions in older adults with heart failure.
RCT (n=1,500)
Single-blind (outcome assessors)
Stratified by medical center
Yes
Does a care transition intervention including pre-discharge education, telephone nurse coaching, and home telemonitoring reduce 180-day all-cause hospital readmissions in older adults hospitalized with decompensated heart failure?
The BEAT-HF trial protocol describes a large-scale randomized study to determine if combining pre-discharge education, telephone nurse coaching, and home telemonitoring reduces 180-day readmissions in patients with decompensated heart failure.
BACKGROUND: Heart failure is a prevalent health problem associated with costly hospital readmissions. Transitional care programs have been shown to reduce readmissions but are costly to implement. Evidence regarding the effectiveness of telemonitoring in managing the care of this chronic condition is mixed. The objective of this randomized controlled comparative effectiveness study is to evaluate the effectiveness of a care transition intervention that includes pre-discharge education about heart failure and post-discharge telephone nurse coaching combined with home telemonitoring of weight, blood pressure, heart rate, and symptoms in reducing all-cause 180-day hospital readmissions for older adults hospitalized with heart failure. METHODS/DESIGN: A multi-center, randomized controlled trial is being conducted at six academic health systems in California. A total of 1,500 patients aged 50 years and older will be enrolled during a hospitalization for treatment of heart failure. Patients in the intervention group will receive intensive patient education using the 'teach-back' method and receive instruction in using the telemonitoring equipment. Following hospital discharge, they will receive a series of nine scheduled health coaching telephone calls over 6 months from nurses located in a centralized call center. The nurses also will call patients and patients' physicians in response to alerts generated by the telemonitoring system, based on predetermined parameters. The primary outcome is readmission for any cause within 180 days. Secondary outcomes include 30-day readmission, mortality, hospital days, emergency department (ED) visits, hospital cost, and health-related quality of life. DISCUSSION: BEAT-HF is one of the largest randomized controlled trials of telemonitoring in patients with heart failure, and the first explicitly to adapt the care transition approach and combine it with remote telemonitoring. The study population also includes patients with a wide range of demographic and socioeconomic characteristics. Once completed, the study will be a rich resource of information on how best to use remote technology in the care management of patients with chronic heart failure. TRIAL REGISTRATION: ClinicalTrials.gov # NCT01360203.
Black et al. (Sat,) conducted a rct in Heart failure (n=1,500). Care transition intervention (pre-discharge education, telephone nurse coaching, and home telemonitoring) vs. Usual care was evaluated on All-cause hospital readmission within 180 days. The BEAT-HF study is an ongoing randomized controlled trial designed to evaluate whether a care transition intervention combining pre-discharge education, telephone nurse coaching, and home telemonitoring reduces 180-day all-cause readmissions in older adults with heart failure.
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