Poster Presentation
Thursday, July 12, 2007
9:30 AM - 10:15 AM
Thursday, July 12, 2007
3:15 PM - 4:00 PM
Telehealth Home Exercise/Disease Management for Heart Failure: A Pilot Study
Jill M. Winters, PhD, RN1, Mary Ann Papp, DO, FACC2, Susan E. Cashin, PhD3, and Heather Seubert, BSN, RN1. (1) College of Nursing, Marquette University, Milwaukee, WI, USA, (2) Cardiology, Medical College of Wisconsin, Milwaukee, WI, USA, (3) College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| Learning Objective #1: identify ways in which telemonitoring can assist in disease management of heart failure. |
| Learning Objective #2: determine the efficacy and benefits of a home exercise program for patients with NYHA Class II-III heart failure. |
Heart failure (HF) affects approximately 5 million Americans, it is the leading cause of death in the United States, and it is the single most costly healthcare challenge. The American College of Cardiology/American Heart Association evidence-based practice guidelines identified exercise as a key factor for managing HF. Exercise intolerance is a fundamental symptom with HF, presenting limitations on functional status and QOL. However, HF rehabilitation program implementation has been challenging. A user-centered telehealth-supported home-based exercise program with frequent feedback may enhance adherence and improve exercise tolerance, HF symptoms, and QOL. Therefore, the purpose of this prospective 2-group experimental study was to compare effects of a 12-week telehealth home exercise rehabilitation and disease management program with usual treatment. It was hypothesized that experimental participants would have greater improvements in functional performance, psychological well-being, and quality of life than those in the control group. This study was guided by the Telehomecare Model for Optimizing Rehabilitation Outcomes. Thirty-six subjects with Class II or III HF will be enrolled. Subjects in both the experimental and control groups undergo submaximal exercise testing and are provided with an exercise prescription. Experimental subjects receive a recumbent stationary bike, Polar™ heart rate monitor, exercise logs, and telemonitoring equipment. Daily monitoring of heart rate (HR), blood pressure (BP), oxygenation (SPO2), and weight are conducted for those in the experimental group, in order to insure that they are safe to exercise and assist in disease management. Regularly scheduled televisits are held with experimental subjects providing telecoaching and telesupport. To date, 24 subjects have been enrolled. Preliminary findings have provided evidence for efficacy and effectiveness of this telehealth based home exercise program. Exercise adherence has been high, and improvements in quality of life, functional performance and psychological well being have been demonstrated. Participant satisfaction has been high.