A Randomized Controlled Trial of Telemonitoring in Older Adults With Multiple Health Issues to Prevent Hospitalizations and Emergency Department Visits
Open accessAbstract
BACKGROUND: Efficiently caring for frail older adults will become an increasingly important part of health care reform;telemonitoring within homes may be an answer to improve outcomes. This study sought to assess differences in hospitalizations and emergency department (ED) visits among older adults using telemonitoring vs usual care. METHODS: A randomized controlled trial was performed among adults older than 60 years at high risk for rehospitalization. Participants were randomized to telemonitoring (with daily input) or to patient-driven usual care. Telemonitoring was accomplished by daily biometrics,symptom reporting, and videoconference. The primary outcome was a composite end point of hospitalizations and ED visits in the 12 months following enrollment. Secondary end points included hospitalizations,ED visits, and total hospital days. Intent-to-treat analysis was performed. RESULTS: Two hundred five participants were enrolled,with a mean age of 80.3 years. The primary outcome of hospitalizations and ED visits did not differ between the telemonitoring group (63.7%) and the usual care group(57.3%) (P=.35). No differences were observed in secondary end points, including hospitalizations, ED visits,and total hospital days. No significant group differences in hospitalizations and ED visits were found between the pre-enrollment period vs the post-enrollment period. Mortality was higher in the telemonitoring group (14.7%)than in the usual care group (3.9%) (P=.008). CONCLUSIONS: Among older patients, telemonitoring did not result in fewer hospitalizations or ED visits. Secondary outcomes demonstrated no significant differences between the telemonitoring group and the usual care group.The cause of greater mortality in the telemonitoring group is unknown.
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Our research population's heterogeneity did not permit a thorough comparison with other studies in the literature as they involved more homogeneous samples.
“Our research population’s heterogeneity did not permit a thorough comparison with other studies in the literature as they involved more homogeneous samples [18-20].”
From Perceptions About Technologies That Help Community-Dwelling Older Adults Remain at Home: Qualitative Study (2020) · cites this paper as [19]
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- Authors
- Takahashi, P. Y., Pecina, J. L., Upatising, B., Chaudhry, R., Shah, N. D., Van Houten, H., Cha, S., Croghan, I., Naessens, J. M., & Hanson, G. J.
- Affiliations
- Mayo Clinic (US)
- Purdue University West Lafayette (US)
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2012-05-28
- Volume
- 172
- Issue
- 10
- Pages
- 773-9
- ISSN
- 0003-9926 (ISSN-L)
- PMC
- PMC3914200
- OpenAlex
- W2106643870
- Cited by
- 218
- References
- 26
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 8 · 2023: 6 · 2022: 9 · 2021: 23 · 2020: 10 · 2019: 8 · 2018: 10 · 2017: 17 · 2016: 18 · 2015: 23 · 2014: 30 · 2013: 25 · 2012: 19
- FWCI
- 29.98
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Research Resources (UL1RR024150)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Demography › Technology Use by Older Adults
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- remote patient monitoring, frail elderly, hospitalization prevention, emergency department visits, hospital readmission, mortality, biometric monitoring, videoconferencing, usual care
- MeSH terms
- Aged, Aged, 80 and over, Chronic Disease, Emergency Service, Hospital, Female, Hospitalization, Humans, Length of Stay, Male, Monitoring, Physiologic, Patient Readmission, Quality Control, Geriatric Assessment, Survival Analysis, Frail Elderly, Cost Savings, Hospital Mortality, Telemedicine, Statistics, Nonparametric, Kaplan-Meier Estimate
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