A comparison of in-person home care, home care with telephone contact and home care with telemonitoring for disease management
Key result
Compared to in-person visits alone, adding telephone contact or telemonitoring did not significantly reduce 60-day rehospitalization in patients with heart failure and diabetes.
Why the study?
Does telephone contact or telemonitoring added to in-person visits reduce rehospitalization in patients with heart failure and diabetes?
Population
303 patients with heart failure and diabetes
Comparison
Evidence-based disease management guidelines… vs In-person visits alone (Control, n=112)
Design
RCT, Randomized to three groups
Follow-up
60 days
Authors
Discussion
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Member takes
Implication
Does not support adding telephone contact or telemonitoring to in-person visits to reduce rehospitalization in HF with diabetes; challenges assumptions of remote monitoring benefit.
Study Design
Type
RCT (n=303)
Randomization
randomized
Structured PICO
Does telephone contact or telemonitoring added to in-person visits reduce rehospitalization in patients with heart failure and diabetes?
P
Population
303 patients with heart failure and diabetes followed for 60 days.
I
Intervention
Evidence-based disease management guidelines delivered via in-person visits and a telephone intervention (n=93) or in-person visits and telemonitoring (n=98)
C
Comparator
In-person visits alone (Control, n=112)
O
Outcome
Rehospitalization during the first 60 dayshard clinical
Main Result
Relative Risk: 2.2 (95% CI 0.9–5.2)
Absolute Event Rate: 17% vs 10%
p-value: p=0.07
Adding telephone contact or telemonitoring to in-person home care did not significantly reduce 60-day rehospitalization in patients with heart failure and diabetes.
Limitations
- Patient rehospitalization and emergency department visit rates were lower than the national average, making it difficult to detect a difference between groups.
Cite This Study
Bowles et al. (2009) conducted an RCT in Heart failure and diabetes (n=303). Home care with telephone contact or telemonitoring vs. In-person visits alone (Control) was evaluated on Rehospitalization (RR 2.2, 95% CI 0.9 to 5.2, p=0.07). Compared to in-person visits alone, adding telephone contact or telemonitoring did not significantly reduce 60-day rehospitalization in patients with heart failure and diabetes.