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November 11, 2015Clinical Nursing StudiesOpen Access

A multimodal technology intervention for heart failure patients to reduce readmissions

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Why the study?

Does a multimodal technology intervention including home telemonitoring and nurse coaching reduce readmissions in heart failure patients?

Population

30 heart failure patients, mean age 75

Comparison

Home telemonitoring devices, telephonic nurse… vs Telephonic nurse coach and motivational…

Design

RCT, Three-arm randomized controlled trial

Key result

A home telemonitoring and motivational interviewing intervention resulted in a 20% readmission rate compared to 56% in the control group over 4 months, though this difference was not statistically significant.

Authors

SHShelley Y. HawkinsTTTanna ThomasonCSCarl Fritz Steen

Discussion

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Overview

Small RCT shows no readmission benefit; leaves open whether HT plus MI coaching improves depression or self-care in larger trials.

Study Design

Type

RCT (n=30)

Blinding

Open-label

Randomization

Random table of numbers

Multicenter

No

Structured PICO

Does a multimodal technology intervention including home telemonitoring and nurse coaching reduce readmissions in heart failure patients?

P
Population
30 older adults (mean age 75) with heart failure recently discharged from the hospital were randomized to a 4-month multimodal telehealth intervention or control.
I
Intervention
Home telemonitoring (HT) devices, telephonic nurse coach (NC), and motivational interviewing (MI) heart failure self-care education (Group A)
C
Comparator
Telephonic nurse coach and motivational interviewing heart failure self-care education without home telemonitoring (Group B), or telephonic nurse coach health promotion only (Group C)
O
Outcome
Readmissionshard clinical

Main Result

Absolute Event Rate: 20% vs 56%

p-value: p=not significant

A multimodal home telemonitoring and nurse coaching intervention did not significantly reduce readmissions in a small pilot of heart failure patients, but showed potential benefits for depression and telemedicine satisfaction.

Limitations

  • Small overall sample size increasing the risk of Type II errors
  • Lack of racial diversification as most study participants were Caucasian
  • Exclusion of non-English speaking (e.g., Spanish speaking) patients
  • Use of novice researchers requiring greater interrater reliability training

Cite This Study

Hawkins et al. (2015) conducted an RCT in Heart failure (n=30). Home telemonitoring and telephonic nurse coach motivational interviewing vs. Telephonic nurse coach health promotion only (Group C) or HF self-care without telemonitoring (Group B) was evaluated on Hospital readmission within 4 months (p=not significant). A home telemonitoring and motivational interviewing intervention resulted in a 20% readmission rate compared to 56% in the control group over 4 months, though this difference was not statistically significant.

synapsesocial.com/papers/6a63bf869a2e487662c22581https://doi.org/10.5430/cns.v4n1p6
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