A randomized trial of telenursing to reduce hospitalization for heart failure: patient-centered outcomes and nursing indicators.
This trial compared 3 post-hospitalization nursing care models for reducing congestive heart failure (CHF) readmission charges during 180-days of follow-up. Subjects received in-person visits at baseline and 60 days plus 1 of 3 care modalities in the interim: (a) video-based home telecare; (b) telephone calls; and (c) usual care. CHF-related readmission charges were > 80% lower in the telenursing groups compared to usual care, and these groups also had significantly fewer CHF-related emergency visits. In-person visits were more than 3 times longer than telenursing visits (p < 0.0001), only partially due to added travel time. Patient self-care adherence, medications, health status, and satisfaction did not significantly differ between groups. Telenursing can reduce CHF hospitalizations and allow increased frequency of communication with patients.
Department of Family and Community Medicine, University of California, Davis, School of Medicine, 4860 Y Street, Suite 2300. Sacramento, CA 95817, USA. afjerant@ucdavis.edu
Anthony F
AF
Jerant
Rahman
R
Azari
Carmen
C
Martinez
Thomas S
TS
Nesbitt
D000368:Aged; D002140:California; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006302:Health Services Research; D006333:Heart Failure / Q000150:complications / Q000451:nursing*; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008297:Male; D016294:Models, Nursing; D009723:Nurse-Patient Relations; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission; D018802:Patient-Centered Care; D012648:Self Care; D017216:Telemedicine