Patient reported experience and adherence to remote patient management in chronic heart failure patients: a posthoc analysis of the TIM-HF2 trial

Eur J Cardiovasc Nurs. 2022 Sep 5:zvac080. doi: 10.1093/eurjcn/zvac080. Online ahead of print.

ABSTRACT

AIMS: Remote Patient Management (RPM) enables early detection and prevention of deterioration in heart failure (HF) patients by measuring vital parameters. The analysis objective is to assess patient reported experience with RPM, adherence to daily measurements, and outline affecting factors both.

METHODS & RESULTS: TIM-HF2 was conducted in 2013-2018 with 1,538 HF patients with a 12-months follow-up. Under guidance of HF nurses patients had to measure daily weight, blood pressure, ECG, and self-rated health status. At the end of the study, patients received a program survey to analyse patient perceptions and satisfaction with telemedicine care and study organisation. Adherence was distinguished between measurement of at least one (incomplete adherence - IA) and all vital parameters (complete adherence - CA) and defined as ratio of the number of days of measurements taken divided by the number of days of possible measurements. All data and group differences were analysed descriptively (mean ± SD) and by ANOVA and T-Test.Survey response rate was 79.7%. Patients were satisfied with the program and device usability. CA was 89.1 ± 14.1%, consistently high over the study course and independent of severity of disease (LVEF, NTproBNP, NYHA). Lower IA was found with patients <70 years and prior to unplanned cardiovascular (CV) hospitalisations (difference by -5.2 ± 20.5%) and after unplanned CV hospitalisations compared to the entire study period (lower by -12.8 ± 24.7%). Patients from rural areas were found to have higher CA than patients from urban regions.

CONCLUSIONS: With user-friendly devices, pre-interventional patient training, regular patient contact and close cooperation between primary physicians and Telemedical Centre (TMC), a long-lasting high adherence and satisfaction could be achieved. A change in adherence might detect health deterioration and indicate the need to intensify RPM.

REGISTRATION: ClinicalTrials.gov (NCT01878630) and Deutsches Register Klinischer Studien (DRKS00010239).

PMID:36062451 | DOI:10.1093/eurjcn/zvac080