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.
Jerant
Anthony F
AF
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
Azari
Rahman
R
Martinez
Carmen
C
Nesbitt
Thomas S
TS
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