Telemonitoring Adherence to Medications in Heart Failure Patients (TEAM-HF): A Pilot Randomized Clinical Trial

J Card Fail. 2017 Apr;23(4):345-349. doi: 10.1016/j.cardfail.2016.11.001. Epub 2016 Nov 3.

Abstract

Background: Medication nonadherence contributes to hospitalizations in recently discharged patients with heart failure (HF). We aimed to test the feasibility of telemonitoring medication adherence in patients with HF.

Methods and results: We randomized 40 patients (1:1) hospitalized for HF to 30 days of loop diuretic adherence monitoring with telephonic support or to passive adherence monitoring alone. Eighty-three percent of eligible patients agreed to participate. The median age of patients was 64 years, 25% were female, and 45% were Hispanic. Overall, 67% of patients were nonadherent (percentage of days that the correct number of doses were taken <88%). There were no differences between intervention and passive monitoring group patients, respectively, in adherence (median correct dosing adherence 82% vs 73%; P = .41) or in the proportion readmitted within 30 days (30% vs 20%; P = .72). Eighty-eight percent of patients rated the wireless electronic adherence device as somewhat or very easy to use, and 88% agreed to use it again.

Conclusions: Adherence telemonitoring was acceptable to most patients with HF. Diuretic nonadherence was common even when patients knew they were being monitored. Future studies should assess whether adherence telemonitoring can improve adherence and reduce readmissions among patients with HF.

Keywords: Heart failure; adherence; interventions; readmissions; self-care; telemonitoring.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Drug Monitoring* / instrumentation
  • Drug Monitoring* / methods
  • Drug Monitoring* / psychology
  • Female
  • Heart Failure / drug therapy*
  • Humans
  • Male
  • Medication Adherence* / psychology
  • Medication Adherence* / statistics & numerical data
  • Middle Aged
  • Outcome Assessment, Health Care
  • Pilot Projects
  • Self Care / methods
  • Self Care / psychology
  • Sodium Potassium Chloride Symporter Inhibitors / therapeutic use*
  • Telemedicine / methods*

Substances

  • Sodium Potassium Chloride Symporter Inhibitors