Abstract P25: Factors Associated with Patients' Adoption and Adherence to a Heart Failure Telemonitoring System

Abstract

Background: Despite numerous studies of telemonitoring (TM), the use of technology to monitor patients remotely, information about patients' adoption and adherence to using such technologies is scarce. The objective of this study was to determine the patient characteristics associated with: 1) initiating use of TM and 2) adherence to using daily TM over 6 months. Methods: We evaluated all 826 patients enrolled in the TM arm of the Tele-HF multicenter RCT. TM consisted of a telephone-based interactive voice response system whereby patients reported symptoms and weight daily for 6 months. The adherence rate was calculated as the # of weeks the patient used the TM system at least 3 days/week over 6-month study period. Multivariable hierarchical regression was used to identify factors independently associated with initiation of and adherence to TM. Results: The mean ± SD age of patients was 61.1 ± 15.3 years (range 19-90), 44% were women, and 50% were of minority race. Overall, 14% (119/ 826) never initiated use of TM. In the multivariable analysis, younger patients (age < 65) and patients with higher satisfaction with care were more likely to initiate TM (p-values ≤ .03) (Figure). Among the 707 patients who initiated TM, adherence averaged 90% in week 1 and 55% in week 26. Younger patients and those with lower health literacy had lower rates of adherence to using TM over 6 months (p-values ≤ .004). Conclusion: Age, satisfaction with care and health literacy were associated with utilization of a TM system for the management of HF. Understanding more about how patient nonclinical factors impact use of new technologies such as TM, may improve the design and effectiveness of TM strategies.