© 2007 European Society of Cardiology
Adherence, adaptation and acceptance of elderly chronic heart failure patients to receiving healthcare via telephone-monitoring
a National Heart Foundation South Australian Branch Australia
b Faculty of Health Sciences, University of South Australia Australia
c Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University Prahran, Victoria, Australia
d Department of General Practice & Primary Health Care, The University of Auckland New Zealand
e School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University East Bentleigh, Vic, Australia
f Department of Preventative Cardiology, Baker Heart Research Institute Prahran Victoria, Australia
* Corresponding author. Department of Epidemiology and Preventive Medicine, Monash University, 3rd Floor, Burnet Tower, AMREP Precinct, Commercial Road, Melbourne, VICTORIA 3004, Australia. Tel.: +61 9903 0046; fax: +61 9903 0576. E-mail address: henry.krum{at}med.monash.edu.au
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Abstract |
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Background: Although the potential to reduce hospitalisation and mortality in chronic heart failure (CHF) is well reported, the feasibility of receiving healthcare by structured telephone support or telemonitoring is not.
Aims: To determine; adherence, adaptation and acceptability to a national nurse-coordinated telephone-monitoring CHF management strategy. The Chronic Heart Failure Assistance by Telephone Study (CHAT).
Methods: Triangulation of descriptive statistics, feedback surveys and qualitative analysis of clinical notes. Cohort comprised of standard care plus intervention (SC+I) participants who completed the first year of the study.
Results: 30 GPs (70% rural) randomised to SC+I recruited 79 eligible participants, of whom 60 (76%) completed the full 12month follow-up period. During this time 3619 calls were made into the CHAT system (mean 45.81 SD±79.26, range 0–369), Overall there was an adherence to the study protocol of 65.8% (95% CI 0.54–0.75; p=0.001) however, of the 60 participants who completed the 12month follow-up period the adherence was significantly higher at 92.3% (95% CI 0.82–0.97, p
0.001). Only 3% of this elderly group (mean age 74.7±9.3years) were unable to learn or competently use the technology. Participants rated CHAT with a total acceptability rate of 76.45%.
Conclusion: This study shows that elderly CHF patients can adapt quickly, find telephone-monitoring an acceptable part of their healthcare routine, and are able to maintain good adherence for a least 12months.
Key Words: Chronic heart failure • Telephone support • Acceptance
Received February 1, 2007; Revised May 27, 2007; Accepted July 16, 2007
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