A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure

Study protocol for the Better Effectiveness After Transition - Heart Failure (BEAT-HF) randomized controlled trial

Jeanne T. Black, Patrick S Romano, Banafsheh Sadeghi, Andrew D. Auerbach, Theodore G. Ganiats, Sheldon Greenfield, Sherrie H. Kaplan, Michael K. Ong

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background: Heart failure is a prevalent health problem associated with costly hospital readmissions. Transitional care programs have been shown to reduce readmissions but are costly to implement. Evidence regarding the effectiveness of telemonitoring in managing the care of this chronic condition is mixed. The objective of this randomized controlled comparative effectiveness study is to evaluate the effectiveness of a care transition intervention that includes pre-discharge education about heart failure and post-discharge telephone nurse coaching combined with home telemonitoring of weight, blood pressure, heart rate, and symptoms in reducing all-cause 180-day hospital readmissions for older adults hospitalized with heart failure.Methods/Design: A multi-center, randomized controlled trial is being conducted at six academic health systems in California. A total of 1,500 patients aged 50 years and older will be enrolled during a hospitalization for treatment of heart failure. Patients in the intervention group will receive intensive patient education using the 'teach-back' method and receive instruction in using the telemonitoring equipment. Following hospital discharge, they will receive a series of nine scheduled health coaching telephone calls over 6 months from nurses located in a centralized call center. The nurses also will call patients and patients' physicians in response to alerts generated by the telemonitoring system, based on predetermined parameters. The primary outcome is readmission for any cause within 180 days. Secondary outcomes include 30-day readmission, mortality, hospital days, emergency department (ED) visits, hospital cost, and health-related quality of life.Discussion: BEAT-HF is one of the largest randomized controlled trials of telemonitoring in patients with heart failure, and the first explicitly to adapt the care transition approach and combine it with remote telemonitoring. The study population also includes patients with a wide range of demographic and socioeconomic characteristics. Once completed, the study will be a rich resource of information on how best to use remote technology in the care management of patients with chronic heart failure.Trial registration: ClinicalTrials.gov # NCT01360203.

Original languageEnglish (US)
Article number124
JournalTrials
Volume15
Issue number1
DOIs
StatePublished - 2014

Fingerprint

Patient Readmission
Telephone
Randomized Controlled Trials
Heart Failure
Nurses
Patient Transfer
Health
Patient Care Management
Hospital Costs
Patient Education
Hospital Mortality
Mentoring
Treatment Failure
Hospital Emergency Service
Hospitalization
Heart Rate
Quality of Life
Demography
Blood Pressure
Technology

Keywords

  • Care coordination
  • Heart failure
  • Nurse coaching
  • Readmission
  • Self-care
  • Telemonitoring

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Pharmacology (medical)

Cite this

A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure : Study protocol for the Better Effectiveness After Transition - Heart Failure (BEAT-HF) randomized controlled trial. / Black, Jeanne T.; Romano, Patrick S; Sadeghi, Banafsheh; Auerbach, Andrew D.; Ganiats, Theodore G.; Greenfield, Sheldon; Kaplan, Sherrie H.; Ong, Michael K.

In: Trials, Vol. 15, No. 1, 124, 2014.

Research output: Contribution to journalArticle

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