title: Adherence, adaptation and acceptance of elderly chronic heart failure patients to receiving healthcare via telephone-monitoring.
abstract: BACKGROUND
  Although the potential to reduce hospitalisation and mortality in chronic heart failure (CHF) is well reported, the feasibility of receiving healthcare by structured telephone support or telemonitoring is not.
  
  
  OBJECTIVE
  To determine; adherence, adaptation and acceptability to a national nurse-coordinated telephone-monitoring CHF management strategy. The Chronic Heart Failure Assistance by Telephone Study (CHAT).
  
  
  METHODS
  Triangulation of descriptive statistics, feedback surveys and qualitative analysis of clinical notes. Cohort comprised of standard care plus intervention (SC+I) participants who completed the first year of the study.
  
  
  RESULTS
  30 GPs (70% rural) randomised to SC+I recruited 79 eligible participants, of whom 60 (76%) completed the full 12 month follow-up period. During this time 3619 calls were made into the CHAT system (mean 45.81 SD+/-79.26, range 0-369), Overall there was an adherence to the study protocol of 65.8% (95% CI 0.54-0.75; p=0.001) however, of the 60 participants who completed the 12 month follow-up period the adherence was significantly higher at 92.3% (95% CI 0.82-0.97, p<or=0.001). Only 3% of this elderly group (mean age 74.7+/-9.3 years) were unable to learn or competently use the technology. Participants rated CHAT with a total acceptability rate of 76.45%.
  
  
  CONCLUSIONS
  This study shows that elderly CHF patients can adapt quickly, find telephone-monitoring an acceptable part of their healthcare routine, and are able to maintain good adherence for a least 12 months.
authors.affiliation: National Heart Foundation South Australian Branch, Australia.
authors.forename: Robyn A
authors.initials: RA
authors.lastname: Clark
authors.forename: Julie J
authors.initials: JJ
authors.lastname: Yallop
authors.forename: Leon
authors.initials: L
authors.lastname: Piterman
authors.forename: Joanne
authors.initials: J
authors.lastname: Croucher
authors.forename: Andrew
authors.initials: A
authors.lastname: Tonkin
authors.forename: Simon
authors.initials: S
authors.lastname: Stewart
authors.forename: Henry
authors.initials: H
authors.lastname: Krum
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001315:Australia; D016009:Chi-Square Distribution; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D012424:Rural Population; D013689:Telephone