The effect of remote patient monitoring on discharge outcomes in post-coronary artery bypass graft surgery patients.
Journal
Journal of the American Association of Nurse Practitioners
ISSN: 2327-6924
Titre abrégé: J Am Assoc Nurse Pract
Pays: United States
ID NLM: 101600770
Informations de publication
Date de publication:
06 May 2020
06 May 2020
Historique:
received:
29
10
2019
accepted:
06
02
2020
pubmed:
10
5
2020
medline:
25
11
2021
entrez:
9
5
2020
Statut:
epublish
Résumé
Coronary artery bypass graft (CABG) surgery is a lifesaving procedure for patients with coronary artery disease but ranks highest (13.5%) for preventable hospital readmissions and second highest in average Medicare payment ($8,136) per readmission. Care transitions after hospital discharge warrant exploration to improve outcomes. The purpose of this brief report was to compare the effect of remote patient monitoring (RPM) on 30-day outcomes in Medicare beneficiaries after isolated CABG surgery. Results demonstrated no statistically significant difference in 30-day readmission (p = .568) or emergency department encounters (p = .785) between groups. However, time to achieve a cardiology follow-up appointment decreased from 19.8 to 13.7 days (p = .062) in the RPM group. Although the findings were not statistically significant, this study demonstrated a reduction in CABG readmissions and timely provider follow-up with RPM. In addition, study findings contribute to the body of nursing knowledge and support the need for further studies to identify high-risk CABG patients who may benefit from RPM after hospital discharge.
Identifiants
pubmed: 32384354
pii: 01741002-202108000-00004
doi: 10.1097/JXX.0000000000000413
doi:
Types de publication
Journal Article
Langues
eng
Pagination
580-585Informations de copyright
Copyright © 2020 American Association of Nurse Practitioners.
Déclaration de conflit d'intérêts
Competing interests: The authors report no conflicts of interest.
Références
Barnason S., Zimmerman L., Nieveen J., Schultz P., Miller C., Hertzog M., Tu C. (2009). Influence of a symptom management telehealth intervention on older adults' early recovery outcomes after coronary artery bypass surgery. Heart and Lung, 38, 364–376.
Benjamin E. J., Muntner P., Alonso A., Bittencourt M. S., Callaway C. W., Carson A. P., Virani S. S. (2019). Heart disease and stroke statistics-2019 update: A report from the American Heart Association. Circulation, 5, 139, e56–e528.
Blum K., Gottlieb S. S. (2014). The effect of a randomized trial of home telemonitoring on medical costs, 30-day readmissions, mortality, and health-related quality of life in a cohort of community-dwelling heart failure patients. Journal of Cardiac Failure, 20, 513–521.
Bojar R. M. (2011). Manual of perioperative care in adult cardiac surgery. (5th ed.). West Sussex, England: Wiley-Blackwell.
Chaudhry S. I., Mattera J. A., Curtis J. P., Spertus J. A., Herrin J., Lin Z., Krumholz H. M. (2010). Telemonitoring in patients with heart failure. The New England Journal of Medicine, 363, 2301–2309.
Daras L. C., Ingber M. J., Carichner J., Barch D., Deutsch A., Smith L. M., Andress J. (2018). Evaluating hospital readmission rates after discharge from inpatient rehabilitation. Archives of Physical Medicine and Rehabilitation, 99, 1049–1059.
Fairbrother P., Ure J., Hanley J., McCloughlin L., Denvir M., Sheikh A., McKinstry B.; Telescot programme team. (2013). Telemonitoring for chronic heart failure: The views of patients and healthcare professionals—a qualitative study. Journal of Clinical Nursing, 23, 132–144.
Inglis S. C., Clark R. A., Dierckx R., Prieto-Marino D., Cleland G. F. (2015). Structured telephone support or non-invasive telemonitoring for patients with heart failure. The Cochrane Database of Systematic Reviews, 1–261.
Keeping-Burke L., Purden M., Frasure-Smith N., Cossette S., McCarthy F., Amsel R. (2013). Bridging the transition from hospital to home: Effects of the VITAL telehealth program on recovery for CABG surgery patients and their caregivers. Research in Nursing & Health, 36, 540–553.
Klersy C., Silvestri A. D., Gabutti G., Raisaro A., Curti M., Regoli F., Auricchio A. (2011). Economic impact of remote patient monitoring: An integrated economic model derived from a meta-analysis of randomized controlled trials in heart failure. European Journal of Heart Failure, 13, 450–459.
Kovacs R. J., Drozda J. P. Jr. (2015). The changing face of team care, and a challenge for the future. Journal of the American College of Cardiology, 65, 2137–2139.
Maeng D. D., Starr A. E., Tomcavage J. F., Sciandra J., Salek D., Griffith D. (2014). Can telemonitoring reduce hospitalization and cost of care? A health plan's experience in managing patients with heart failure. Population Health Management, 16, 340–344.
McElroy I., Sareh S., Zhu A., Miranda G., Wu H., Nguyen M., Benharash P. (2016). Use of digital health kits to reduce readmission after cardiac surgery. Journal of Surgical Research, 204, 1–7.
Medicare Payment Advisory Commission (MedPAC). (2008). Report to the Congress: Reforming the delivery system. Retrieved from http://www.medpac.gov/docs/default source/reports/Jun08_EntireReport.pdf.
Medicare Payment Advisory Commission (MedPAC). (2018). Mandated report: Telehealth and the Medicare program. Retrieved from http://www.medpac.gov/docs/default source/reports/mar18_medpac_ch16_sec.pdf?sfvrsn=0.
National Heart, Lung, and Blood Institute (NHLBI). (2016). What is atherosclerosis? Retrieved from https://www.nhlbi.nih.gov/health/health-topics/topics/atherosclerosis.
Ong M. K., Romano P. S., Edgington S., Aronow H. U., Auerbach A. D., Black J. T., Fonarow G. C.; Effectiveness After Transition-Heart Failure (BEAT-HF) Research Group. (2016). Effectiveness of remote patient monitoring after discharge of hospitalized patients with heart failure: The better effectiveness after transition-heart failure (BEAT-HF) randomized clinical trial. JAMA Internal Medicine, 176, 310–318.
Society of Thoracic Surgeons (STS). (2017). Adult cardiac surgery harvest 1 2017 report. Retrieved from Duke University Clinical Research Institute. https://outcomes.dcri.duke.edu/registry/app/reports.faces.
Soundarraj D., Singh V., Satija V., Thakur R. K. (2017). Containing the cost of heart failure management: A focus on reducing readmissions. Heart Failure Clinics, 13, 21–28.