JMIR Publications

ABSTRACT

Background:

Chronic heart failure (HF) is a chronic disease with an increasing prevalence and a high burden to individuals patients and society. Telemonitoring may be able to mitigate some of this burden by increasing self-management and preventing healthcare utilization. However, it is unknown to which degree telemonitoring has been adopted by hospitals and if the use of telemonitoring is associated with certain patient characteristics. Insight in the dissemination of this technology among hospitals and patients may inform strategies for further adoption.

Objective:

To explore the use of telemonitoring among hospitals in the Netherlands and to identify patient characteristics associated with the use of telemonitoring for HF.

Methods:

We performed a retrospective cohort study based on routinely collected healthcare claim data in the Netherlands. Descriptive analyses were used to gain insight in the adoption of telemonitoring for HF among hospitals in 2019. We used logistic multiple regression analyses to explore the associations between patient characteristics and telemonitoring use.

Results:

Less than half (31/84, 36,9%) of all hospitals had claims for telemonitoring and 6% (5/84) of hospitals had more than 10% of their respective HF populations on telemonitoring. Odds ratios (ORs) for using telemonitoring were higher for men (adjusted OR 1.90, 95% CI 1.50-2.41), and patients with previous hospital treatment for HF (adjusted OR 1.76, 95% CI 1.39-2,24). ORs were lower for higher age categories and were lowest for highest age category consisting of patients older than 80 years (OR 0.30, 95% CI 0.21-0.44) compared to the reference age category (18-59 years). Socioeconomic status, degree of multimorbidity and excessive polypharmacy were not associated with the use of telemonitoring.

Conclusions:

The use of reimbursed telemonitoring for HF was limited up to 2019 and hospitals deployed telemonitoring to different degrees. Elderly, women, and patients with no previous hospital treatment for HF were less likely to use telemonitoring for HF. Future studies should focus on the implementation and dissemination process of telemonitoring which likely accelerated due to the COVID-19 pandemic. In addition, the underlying mechanism of the reported associations should be identified in order to use telemonitoring for those patients that stand to benefit and adapt telemonitoring programs to patients’ needs.