Abstract 117: Telemonitoring in a Low Income African American Population with Congestive Heart Failure: A Pilot Project

Abstract

Background: Telemonitoring (TM) reduces hospital readmissions & mortality in patients with congestive heart failure (CHF). The role of TM in low-income African American (AA) populations is not known. Aim: To determine the feasibility of using TM in a low-income AA population & measure patient satisfaction with TM. Methods: We conducted a prospective study of 15 patients with CHF & reduced ejection fraction (EF < 45%) randomly selected from a Cleveland Clinic outpatient clinic serving a low-income AA population. Each patient received a tablet monitor (Healthcare Access Tablet, BL Healthcare, Inc.), blood pressure (BP) machine, weight scale & pulse oximeter. The TM system was used to remind patients to take their medications & to measure & transmit the patients’ vital signs information to a secure website. The information was assessed daily by a nurse to identify abnormal parameters. Abnormal parameters were defined as BP equal to or greater than 140/90 mm of Hg, heart rate equal to or greater than 100 bpm, weight gain of more than 2 lbs/day & oxygen saturation less than 90%. Patients & their physicians were contacted following a pre-defined algorithm in case of absent readings or abnormal parameters. At the end of the 28-day study period patients were surveyed about their satisfaction with the TM. Results: The average age was 65 years & 80% of participants were male. They had multiple chronic medical conditions (8.6±3.6) & were taking multiple medications (10.6±2.4). Of the 15 patients, 13 were monitored during the study period (one could not be contacted & one had a defective TM system). BP with heart rate, weight, & pulse oximetry were recorded on 73.7±26.3%, 62.5±32.7%, & 51.5±30.9% of the study days, respectively. Twelve patients completed the survey & reported that the TM system was extremely easy 75% (n=9) or easy 25% (n=3) to use (Figure 1). All expressed interest in continuing to use the TM & 11 thought that the close monitoring improved the compliance to medical therapy (Figure 1). Conclusion: Using TM in a low-income AA population with CHF is feasible & associated with high patient satisfaction. TM may identify abnormal vital signs & increase patient’s compliance to medical therapy. Whether TM is a cost effective tool to improve clinical outcomes in low-income African American patients with CHF needs to be proven in larger studies.