Telemonitoring Adherence to Medications in Heart Failure Patients (TEAM-HF): A Pilot Randomized Clinical Trial.
BACKGROUND
Medication nonadherence contributes to hospitalizations in recently discharged patients with heart failure (HF). We aimed to test the feasibility of telemonitoring medication adherence in patients with HF.


RESULTS
We randomized 40 patients (1:1) hospitalized for HF to 30 days of loop diuretic adherence monitoring with telephonic support or to passive adherence monitoring alone. Eighty-three percent of eligible patients agreed to participate. The median age of patients was 64 years, 25% were female, and 45% were Hispanic. Overall, 67% of patients were nonadherent (percentage of days that the correct number of doses were taken <88%). There were no differences between intervention and passive monitoring group patients, respectively, in adherence (median correct dosing adherence 82% vs 73%; P = .41) or in the proportion readmitted within 30 days (30% vs 20%; P = .72). Eighty-eight percent of patients rated the wireless electronic adherence device as somewhat or very easy to use, and 88% agreed to use it again.


CONCLUSIONS
Adherence telemonitoring was acceptable to most patients with HF. Diuretic nonadherence was common even when patients knew they were being monitored. Future studies should assess whether adherence telemonitoring can improve adherence and reduce readmissions among patients with HF.
Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, New York.
Benjamin D
BD
Gallagher
Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, New York.
Nathalie
N
Moise
Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, New York.
Mytra
M
Haerizadeh
Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, New York.
Siqin
S
Ye
Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, New York.
Vivian
V
Medina
Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, New York. Electronic address: ik2293@columbia.edu.
Ian M
IM
Kronish
D016903:Drug Monitoring / Q000295:instrumentation / Q000379:methods / Q000523:psychology; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D012648:Self Care / Q000379:methods / Q000523:psychology; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000627:therapeutic use*; D017216:Telemedicine / Q000379:methods*
D049994:Sodium Potassium Chloride Symporter Inhibitors
Heart failure; adherence; interventions; readmissions; self-care; telemonitoring