JMIR Publications

ABSTRACT

Background:

Heart Failure (HF) is a prevalent condition among older adults in Canada, often leading to reduced quality of life and frequent hospitalizations. Heart Failure Disease Management Interventions (HFDMIs), particularly those delivered through telehealth, aim to improve care by fostering self-care and reducing readmissions. However, disparities in access and utilization of heart failure telehealth services persist within marginalized populations.

Objective:

The purpose of this paper is to present the findings of a scoping review and a rapid realist synthesis around HF telehealth interventions for vulnerable groups of patients with HF. This review is underpinned by the meta-theory of CR and intersectionality theory.

Methods:

A rapid realist synthesis was undertaken for the retrieved literature to explore the underlying mechanisms and contexts that make HF telehealth interventions work or not work for marginalized groups of HF patients.

Results:

The realist review findings indicate that vulnerable patients require simple interventions. The findings also suggest that for effective utilization of telehealth and remote monitoring services, these patients require simplified training that could increase their confidence. The review findings have also demonstrated that involving patients’ family members in the delivery of telehealth interventions ensures success.

Conclusions:

Future research with vulnerable populations should be underpinned by the critical/ intersectionality theory and should apply the principles of intersectionality at all stages of the research process, including evaluation and analysis. This review also urges HF practitioners to apply the principles of intersectionality and health equity in clinical practice, such that the interventions are simple, personalized, involve family members, include an in-person component, include patients’ and health professionals’ training, and integrate telemonitoring data.