Learning Objective #1: describe how telemonitoring can be used in the home setting for patients with heart failure.

Learning Objective #2: describe whether telemonitoring is effective for heart failure patients post hospitalization.

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Background:  Heart Failure is a leading cause of hospital readmissions for those over 65 years of age. Telemonitoring has the potential to decrease readmissions.  The purposes of this secondary data analysis were to (1) examine compliance with telemonitoring and (2) assess differences in psychological and physiological measures between heart failure patients who were readmitted or not readmitted to the hospital.  Methods: Eighty-four heart failure patients who were 65 years of age were interviewed in their homes soon after hospital discharge and three months later.  Half of the patients received an upright scale that was connected via the telephone line to a computer monitoring system at the participating hospital.  The heart failure care manager electronically monitored the patients on a daily basis.  She recorded the use of the scale and the number of days that the patients' symptoms were outside of normal parameters.  Results: On average, patients used the scale 78 out of 94 days, and the nurse  called the patients who exhibited adverse symptoms an average of 26 times.  Adherence to the treatment plan was significantly related at Time 1 and Time 2.  Thirty percent of the patients were readmitted within 3 months of discharge.  There were no significant differences in the number of hospital readmissions between those with/without telemonitoring.  There were no significant differences between depressive symptoms, adherence to the treatment plan, prescribed heart medications, oxygen saturation level, and systolic and diastolic pressure between those readmitted/not readmitted to the hospital.  Those readmitted to the hospital reported more informal social support, and they had greater severity of illness at Time 2 of data collection.   Conclusion:  Although telemonitoring did not significantly decrease hospital readmissions, patients used the scale regularly.  This use may encourage further compliance with diet and medications.  Further research should explore the benefits of electronic home monitoring of heart failure patients.