Authors (including presenting author) :
Chan YM, Lee WS, Yiu SC, Pun SD, Lam SY, Lee PY
Affiliation :
Cardiac Care Unit, North District Hospital
Introduction :
Home-telemonitoring can improve outcome of congested heart failure (CHF) by earlier detection of clinical deterioration. Telemonitoring provided patients with self-management support resulting in empowerment, self-care, quality of life (Evangelista, et al., 2015) and exercise tolerance (Bernocchi, et al., 2018). Remote monitoring was able to reduce heart failure related hospitalization and all-cause mortality (Kitsiou, Pare, Jaana, 2015). Heart Failure Support Scheme (HFSS) is a telemonitoring program piloted in the North District Hospital in early 2018, targeted patients with CHF.
Objectives :
HFSS aims at enhance and empower CHF patients in self-management and closely monitor discharged CHF patient. It also aims at detecting the signs and symptoms of fluid overload, providing appropriate interventions to prevent unplanned CHF readmission.
Methodology :
CHF is defined as left ventricular ejection fraction of less than 40%. Patients were referred by Electronic Diagnostic Unit and physicians. Case suitability to join telemonitoring program would be screened by cardiac nurses with list of exclusion criteria. A face-to-face health education before discharge, focusing on self-management of CHF including usage of “edema package” and “TeleTrek” would be delivered to recruited case. “Teletrek”, an electronic device, would be provided to the recruited cases, whom would undergo a 2-weeks telemonitoring program at home. The recruited cases would input daily physiological parameters and answer 5 heart-failure related questions through “Teletrek”. Cardiac nurses would monitor patients’ condition through Teletrek website, where intervention will be provided if necessary. Structured phone follow-up would be provided at the first and fourth week upon discharge. For cases needed further medical attention, cardiac nurses would report and discuss with cardiologists. Satisfaction evaluation of HFSS would be conducted at the end of the program (i.e. 4th week after discharge).
Result & Outcome :
From April 2018 to November 2018, 42 cases were referred and 16 cases were recruited. 12 cases completed the program. Ten patients were male and two patients were female. The mean age was 59 (range 38-68). All 12 cases completed the whole program and there was no unplanned readmission within the 4 weeks period. One case needed further medical advice from the cardiologist for drug titration and one case needed additional phone follow-up by cardiac nurse for detailed education due to drug compliance issue. All participates completed the evaluation form at the end of program and all of them satisfied with the telemonitoring program.
Co-location with:
