Impact of a Telehealth-Based Program on Hospital Readmission, Patient Knowledge, and Self-Care Among Older Adults with Heart Failure

Heart failure (HF) is a global epidemic that affects older populations at an unprecedented rate. It is one of the leading causes of hospital readmission in patients 65 years and older. Although many strategies have been used to properly manage the disease, HF remains a complex condition due to several factors such as disease progression, comorbidities, inadequate patient knowledge, and non-adherence to the treatment plan. Despite the impact of HF on quality of life, morbidity, and mortality in older adults, they have been markedly underrepresented in most major cardiovascular trials. Besides the use of traditional methods for HF management, studies have shown that telehealth can be an effective strategy to provide the necessary education and assistance to patients, reducing the need for unnecessary ER visits. A quality improvement (QI) project involving 10 participants diagnosed with HF was implemented from June to September 2022. The aim of this project was to measure the effect of a telehealth-based HF program on HF knowledge, self-care adequacy, and hospital readmission among patients ≥ 65 years diagnosed with HF. To achieve this objective, a system including remote symptoms monitoring along with weekly education sessions on HF self-management was implemented. After using measurement tools (Dutch Heart Failure Knowledge Scale and Self-Care Heart Failure Index) and analyzing data, a statistically significant improvement (p< .001) in HF knowledge and self-care adequacy, and a decrease overall in hospital readmissions over a 3 month-period was noted. However, due to certain limitations such as small local sample size, unintended bias, and lack of diversity among participants, the results could not be generalized, and further experimental studies were warranted. Although we value the importance of telehealth, we strongly encouraged in-person visits for thorough physical examination, and we educated patients to identify red flags that warrant a visit to the emergency.