A Multimodal Telehealth Heart Failure Patient Behavior Change Intervention to Promote Self-Care and Reduce Readmissions

Purpose: The purpose of this feasibility study is to determine if older adult Heart Failure (HF) patients who have recently been discharged from the hospital will experience a reduction in readmissions when participating in a multimoddal telehealth motivational interviewing HF self-care educational intervention.  The secondary purpose is to determine if the telehealth MI older adult HF patients experience a reduction in readmissions when compared to (1) older adult HF patients who have a MI self-care educational intervention, and (2) older adult HF patients who have a traditional approach health promotion educational intervention.

Methods: This study is a pre-test/post-test mixed methods design that will enroll 30 male and female HF patients to one of three groups consisting of one experimental and two attentional control groups based on propensity score matching.  Inclusion criteria include (1) aged 60 or older, (2) primary or secondary diagnosis of HF, (3) speaks and reads English, (4) has a landline telephone, and (5) earns a minimum score of 8 on the Short Portable Mental Status Questionnaire. Subjects will be recruited 48 hours prior to or immediately following hospital discharge. At the time of recruitment and 4 months later, each subject will complete 4 instruments: Self-Care Heart Failure Index, Telemedicine Perception Questionnaire, Geriatric Depression Scale, and Test of Functional Health Literacy in Adults. Throughout the 4-month intervention, qualitative data will be collected about the experience of HF self-care. Experimental subjects will receive a wireless home telemonitoring weight scale and blood pressure monitor along with a monthly MI HF self-care educational intervention.  Attentional control group one will receive a monthly MI HF self-care educational intervention and attentional control group two will receive a monthly health promotion educational intervention. Data will be analyzed using descriptive statistics, a 3 x 2 ANOVA, and content analysis.

Results: The study intervention has recently been completed.  Data analysis is in progress.  

Conclusion: HF patient readmissions may potentially be reduced or prevented if warning signs and symptoms of decompensation can be identified and managed before the patient’s condition becomes emergent.  Patients who are empowered with individualized HF self-care knowledge and skills using a multimodal telehealth educational intervention may be better able to manage their self-care and reduce or prevent the incidence of readmissions.