Why patients stop using their home telehealth technologies over time: Predictors of discontinuation in Veterans with heart failure.
Aged
Aged, 80 and over
Cohort Studies
Female
Heart Failure
/ psychology
Hospitalization
/ statistics & numerical data
Humans
Male
Middle Aged
Retrospective Studies
Telemedicine
/ instrumentation
Treatment Adherence and Compliance
/ psychology
United States
United States Department of Veterans Affairs
/ organization & administration
Drop-out
Heart failure
Home telehealth
Remote patient monitoring
Veterans
Journal
Nursing outlook
ISSN: 1528-3968
Titre abrégé: Nurs Outlook
Pays: United States
ID NLM: 0401075
Informations de publication
Date de publication:
Historique:
received:
30
06
2020
revised:
15
10
2020
accepted:
03
11
2020
pubmed:
7
12
2020
medline:
13
4
2021
entrez:
6
12
2020
Statut:
ppublish
Résumé
Daily use of home telehealth (HT) technologies decreases over time. Barriers to continued use are unclear. To examine predictors of drop-out from HT in Veterans with heart failure. Data for Veterans with heart failure enrolled in the Veterans Affairs HT Program were analyzed using a mixed effects Cox regression model to determine risk of dropping-out over a 1-year period. Older (hazard ratio [HR] 1.01), sicker (prior hospital readmission [HR 1.39]), higher probability of hospital admission/death [HR 1.23], functional impairments [1.14]) and white Veterans (compared to black; HR 1.41) had higher risk of drop-out in HT Programs. Users of VA's online patient portal (HR 0.90) had lower risk of drop-out. Older and sicker patients are at most risk of stopping HT use, yet use of a patient portal shows promise in improving continued use. Interventions targeting patients at high risk for HT discontinuation are needed to promote ongoing engagement.
Sections du résumé
BACKGROUND
Daily use of home telehealth (HT) technologies decreases over time. Barriers to continued use are unclear.
PURPOSE
To examine predictors of drop-out from HT in Veterans with heart failure.
METHODS
Data for Veterans with heart failure enrolled in the Veterans Affairs HT Program were analyzed using a mixed effects Cox regression model to determine risk of dropping-out over a 1-year period.
FINDINGS
Older (hazard ratio [HR] 1.01), sicker (prior hospital readmission [HR 1.39]), higher probability of hospital admission/death [HR 1.23], functional impairments [1.14]) and white Veterans (compared to black; HR 1.41) had higher risk of drop-out in HT Programs. Users of VA's online patient portal (HR 0.90) had lower risk of drop-out.
DISCUSSION
Older and sicker patients are at most risk of stopping HT use, yet use of a patient portal shows promise in improving continued use. Interventions targeting patients at high risk for HT discontinuation are needed to promote ongoing engagement.
Identifiants
pubmed: 33279151
pii: S0029-6554(20)30696-5
doi: 10.1016/j.outlook.2020.11.004
pmc: PMC8005439
mid: NIHMS1655375
pii:
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
159-166Subventions
Organisme : HSRD VA
ID : IK3 HX001608
Pays : United States
Organisme : ORD VA
ID : RES 13-457
Pays : United States
Informations de copyright
Published by Elsevier Inc.
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