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April 17, 2012Archives of Internal MedicineOpen Access

A Randomized Controlled Trial of Telemonitoring in Older Adults With Multiple Health Issues to Prevent Hospitalizations and Emergency Department Visits

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Key result

Telemonitoring did not reduce hospitalizations and ED visits compared to usual care (63.7% vs 57.3%, P=0.35), but was associated with higher mortality (14.7% vs 3.9%, P=0.008).

Why the study?

Does telemonitoring reduce hospitalizations and ED visits in older adults at high risk for rehospitalization?

Population

205 adults older than 60 years at high risk for rehospitalization, mean age 80.3 years.

Comparison

Telemonitoring vs Patient-driven usual care

Design

RCT, randomized

Follow-up

12 months

Authors

PTPaul Y. TakahashiJPJennifer L. PecinaBUBenjavan Upatising

Discussion

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Overview

Telemonitoring should not be used to reduce hospitalizations in high-risk older adults; challenges assumptions of benefit and signals potential harm.

Study Design

Type

RCT (n=205)

Structured PICO

Does telemonitoring reduce hospitalizations and ED visits in older adults at high risk for rehospitalization?

P
Population
205 adults older than 60 years at high risk for rehospitalization, mean age 80.3 years.
I
Intervention
Telemonitoring (with daily input including biometrics, symptom reporting, and videoconference)
C
Comparator
Patient-driven usual care
O
Outcome
Composite end point of hospitalizations and emergency department (ED) visits in the 12 months following enrollmentcomposite

Main Result

Absolute Event Rate: 63.7% vs 57.3%

p-value: p=0.35

Telemonitoring did not reduce hospitalizations or ED visits in high-risk older adults and was associated with an unexplained higher mortality rate.

Limitations

  • The cause of greater mortality in the telemonitoring group is unknown.

Cite This Study

Takahashi et al. (2012) conducted an RCT in Older adults at high risk for rehospitalization (n=205). Telemonitoring vs. Patient-driven usual care was evaluated on Composite end point of hospitalizations and ED visits (p=0.35). Telemonitoring did not reduce hospitalizations and ED visits compared to usual care (63.7% vs 57.3%, P=0.35), but was associated with higher mortality (14.7% vs 3.9%, P=0.008).

synapsesocial.com/papers/6a109ca3d91177df95fce92fhttps://doi.org/10.1001/archinternmed.2012.256
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A Randomized Trial of Telemonitoring Heart Failure Patients2010 · 33 citations
  2. 2Tailored Telemonitoring in Patients with Heart Failure: Results of a Multicentre Randomized Controlled Trial2012 · 128 citations
  3. 3Impact of telemonitoring home care patients with heart failure or chronic lung disease from primary care on healthcare resource use (the TELBIL study randomised controlled trial)2013 · 99 citations
  4. 4Telemonitoring in-home complex chronic patients from primary care in routine clinical practice: Impact on healthcare resources use2017 · 33 citations
  5. 5Effectiveness of a home-based telesurveillance program in reducing hospital readmissions in older patients with chronic disease: The eCOBAHLT randomized controlled trial2023 · 24 citations