JMIR Publications

ABSTRACT

Background:

Telemonitoring enables care providers to remotely support outpatients in self-managing Chronic Heart Failure (CHF), but objective assessment of patient compliance with self-management recommendations has seldom been studied.

Objective:

To evaluate patient compliance with self-management recommendations of an Innovative Telemonitoring Enhanced Care program for CHF, named the ITEC-CHF study.

Methods:

We conducted a multicenter randomized controlled trial with six-month follow-up. The ITEC-CHF program comprised the provision of Bluetooth-enabled scales linked to a call center and nursing support, to assist participants with weight monitoring compliance. Compliance was defined a priori as weighing at least four days per week, analyzed objectively from weight recordings on the scales. Analysis was by intention-to-treat.

Results:

184 participants, aged 70.1±12.3 years (mean±SD), 76% male, were randomized to receive either ITEC-CHF (n=91) or usual care (CONTROL) (n=93), with 67 ITEC-CHF and 81 CONTROL participants completing the intervention. For the compliance criterion of weighing at least four days per week, the proportion of compliant participants in ITEC-CHF versus CONTROL did not achieve statistical significance (ITEC-CHF, n=67, 74% vs CONTROL, n=56, 60%; P=0.061). However, the proportion of ITEC-CHF participants achieving the stricter compliance standard of at least six days a week was significantly higher than CONTROL (ITEC-CHF, n=41, 45% vs CONTROL, n=23, 25%; P=0.005).

Conclusions:

ITEC-CHF improved participant compliance with weight monitoring, although the withdrawal rate was high. Telemonitoring is a promising method for supporting both patients and clinicians in the management of CHF. However, further refinements are required to optimize this model of care. Clinical Trial: The trial was registered with Australian New Zealand Clinical Trial Registry (Trial ID: ACTRN 12614000916640)