Effectiveness of a telehealth intervention on functional status, anxiety, depression, and rehospitalization among older adults undergoing coronary artery bypass grafting: A randomized controlled trial (Preprint)

BACKGROUND Telehealth has shown promise in enhancing care transitions and physical health outcomes in patients with cardiovascular disease. However, limited studies have explored its effect on functional status, psychological health, and rehospitalization, specifically in older patients undergoing coronary artery bypass grafting (CABG). OBJECTIVE This study aimed to evaluate the effectiveness of a telehealth intervention in improving functional status, reducing anxiety and depression, and decreasing rehospitalization rates compared with usual care among older patients undergoing CABG. METHODS The study was a two-arm parallel randomized controlled trial. This was conducted in two phases. Phase 1 was conducted in the cardiac surgical units at a university hospital in Bangkok, Thailand. Phase 2 involved following up with the participant at home 30 and 90 days after discharge. A total of 84 older adults undergoing CABG were randomly assigned to either the control group (n = 42), which received usual care (discharge planning), or the intervention group (n = 42), which received a telehealth intervention based on the Transitional Care Model in addition to usual care. The telehealth intervention included home monitoring via the “Zip Heart” application and scheduled video consultations. The primary outcome was functional status, measured using the Thai version of the Enforced Social Dependency Scale (Thai ESDS). Secondary outcomes included anxiety and depression, assessed using the Thai Hospital Anxiety and Depression Scale (Thai HADS), and rates of rehospitalization. Data were collected at baseline, 30 and 90 days after discharge. Data analyses were performed using two-way repeated-measures analysis of variance. RESULTS A total of 41 participants in each group completed the study. Significant improvements in functional status and reductions in anxiety and depression at 30 and 90 days after discharge were observed in the intervention group compared to the control group. Additionally, the intervention group demonstrated lower rehospitalization rates at both time points. CONCLUSIONS The Telehealth intervention is effective in improving functional and psychological outcomes and reducing rehospitalization rates among older patients undergoing CABG. Integrating telehealth into usual care can support recovery and enhance continuity of care. CLINICALTRIAL ClinicalTrials.govTCTR20230816008;http://clinicaltrials.gov/ct2/show/TCTR20230816008