JMIR Publications

ABSTRACT

Background:

Non-invasive telemonitoring (TM) can be used in heart failure (HF) patients to perform early detection of decompensation at home, prevent unnecessary healthcare utilization, and decrease healthcare costs. However, the evidence is not sufficient to be part of HF guidelines for follow-up care and we have no knowledge of how TM is used in the Nordic Baltic region.

Objective:

The aim was to describe health care professionals’ (HCPs) (1) perception of and presumed experience with non-invasive TM in daily HF patient care, (2) perspectives of the relevance of and reasons for applying non- invasive TM and (3) barriers to the use of non-invasive TM.

Methods:

A cross-sectional survey was performed between September and December 2016 in Norway and in Lithuania with physicians and nurses treating HF patients at either a hospital ward or an outpatient clinic. A total of 784 questionnaires were sent nationwide by postal mail to 107 hospitals. The questionnaire consisted of 43-items with closed- and open- ended questions. In Norway, the response rate was 69%, with 57 of 60 hospitals participating, whereas the response rate was 68% in Lithuania, with 41 of 47 hospitals participating. Responses to the closed questions were analyzed using descriptive statistics and the open-ended questions were analyzed using summative content analysis.

Results:

This study showed that non-invasive TM is not part of current daily clinical practice in Norway or Lithuania. A minority of HCPs responded to be familiar with non-invasive TM in HF care in Norway (48 of 226, 21%) and in Lithuania (64 of 310, 20%). Around half of the HCPs in both countries perceived non-invasive TM to be relevant in follow-up of HF patients in Norway (58%) and Lithuania (49%). For physicians in both countries and nurses in Norway the three most mentioned reasons for introducing non-invasive TM were: to improve self-care, to reduce hospitalizations and to provide high quality care, while the Lithuanian nurses described: ability to treat more patients and reducing their workload. The main barriers to implement non-invasive TM were lack of funding from health care authorities or the Territorial Patient Fund. Moreover, HCPs perceive HF patients’ themselves could represent barriers due their physical or mental condition in addition to a lack of internet access.

Conclusions:

HCPs in Norway and Lithuania are currently non-users of TM in daily HF care. However, they perceive a future with TM to improve the quality of care for HF patients. Financial barriers and HF patients’ condition may have an impact on the use of TM, whereas sufficient funding from health care authorities and improved knowledge may encourage the more widespread use of TM in the Nordic Baltic region and beyond.