Effectiveness of Remote Patient Monitoring After Discharge of Hospitalized Patients With Heart Failure: The Better Effectiveness After Transition–Heart Failure (BEAT-HF) Randomized Clinical Trial
Open accessAbstract
IMPORTANCE: It remains unclear whether telemonitoring approaches provide benefits for patients with heart failure (HF) after hospitalization. OBJECTIVE: To evaluate the effectiveness of a care transition intervention using remote patient monitoring in reducing 180-day all-cause readmissions among a broad population of older adults hospitalized with HF. DESIGN, SETTING, AND PARTICIPANTS: We randomized 1437 patients hospitalized for HF between October 12, 2011, and September 30, 2013, to the intervention arm (715 patients) or to the usual care arm (722 patients) of the Better Effectiveness After Transition-Heart Failure (BEAT-HF) study and observed them for 180 days. The dates of our study analysis were March 30, 2014, to October 1, 2015. The setting was 6 academic medical centers in California. Participants were hospitalized individuals 50 years or older who received active treatment for decompensated HF. INTERVENTIONS: The intervention combined health coaching telephone calls and telemonitoring. Telemonitoring used electronic equipment that collected daily information about blood pressure, heart rate, symptoms, and weight. Centralized registered nurses conducted telemonitoring reviews, protocolized actions, and telephone calls. MAIN OUTCOMES AND MEASURES: The primary outcome was readmission for any cause within 180 days after discharge. Secondary outcomes were all-cause readmission within 30 days, all-cause mortality at 30 and 180 days, and quality of life at 30 and 180 days. RESULTS: Among 1437 participants, the median age was 73 years. Overall, 46.2% (664 of 1437) were female, and 22.0% (316 of 1437) were African American. The intervention and usual care groups did not differ significantly in readmissions for any cause 180 days after discharge, which occurred in 50.8% (363 of 715) and 49.2% (355 of 722) of patients, respectively (adjusted hazard ratio, 1.03; 95% CI, 0.88-1.20; P = .74). In secondary analyses, there were no significant differences in 30-day readmission or 180-day mortality, but there was a significant difference in 180-day quality of life between the intervention and usual care groups. No adverse events were reported. CONCLUSIONS AND RELEVANCE: Among patients hospitalized for HF, combined health coaching telephone calls and telemonitoring did not reduce 180-day readmissions. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01360203.
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4 (33%) of the 12 studies showed no difference in adherence when compared with a comparator.
“whereas 4 (33%) [30,51,66,84] showed no difference when compared with a comparator.”
From Interactive Remote Patient Monitoring Devices for Managing Chronic Health Conditions: Systematic Review and Meta-analysis (2022) · cites this paper as [84]
The TEN-HMS, TIM-HF and BEAT-HF trials showed that a remote telemonitoring intervention did not reduce heart failure hospitalizations and all-cause mortality.
“TEN-HMS, TIM-HF and BEAT-HF trials showed that a remote telemonitoring intervention did not reduce HF hospitalizations and all-cause mortality68–70”
From Smart wearable devices in cardiovascular care: Where we are and how to move forward (2021) · cites this paper as [70]
In the BEAT-HF study, the remote care intervention did not lower the rate of hospital readmission for any cause at 30 days or 180 days after hospital discharge.
“Moreover, the remote care intervention did not lower the rate of hospital readmission for any cause at 30 days or 180 days after hospital discharge70.”
From Smart wearable devices in cardiovascular care: Where we are and how to move forward (2021) · cites this paper as [70]
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- Authors
- Ong, M. K., Romano, P. S., Edgington, S., Aronow, H. U., Auerbach, A. D., Black, J. T., De Marco, T., Escarce, J. J., Evangelista, L. S., Hanna, B., Ganiats, T. G., Greenberg, B. H., Greenfield, S., Kaplan, S. H., Kimchi, A., Liu, H., Lombardo, D., Mangione, C. M., Sadeghi, B., Sadeghi, B., Sarrafzadeh, M., Tong, K., Fonarow, G. C., & for the Better Effectiveness After Transition–Heart Failure (BEAT-HF) Research Group
- Affiliations
- University of California, Los Angeles (US)
- University of California, Davis (US)
- Cedars-Sinai Medical Center (US)
- University of California, San Francisco (US)
- Department of Medicine, University of California, San Francisco
- Department of Medicine, University of California, Los Angeles8Department of Health Policy & Management, University of California, Los Angeles9RAND Health, RAND Corporation, Santa Monica, California
- University of California, Irvine (US)
- Department of Family and Preventive Medicine, University of California, San Diego13Department of Family Medicine and Community Health, University of Miami, Miami, Florida
- University of California San Diego (US)
- Corresponding author
- Ong, Michael K.
- ORCID
- Ong, Michael K.
- Romano, Patrick S.
- Edgington, Sarah
- Aronow, Harriet U.
- Auerbach, Andrew D.
- Black, Jeanne T.
- Evangelista, Lorraine S.
- Greenberg, Barry H.
- Greenfield, Sheldon
- Kaplan, Sherrie H.
- Kimchi, Asher
- Liu, Honghu
- Lombardo, Dawn
- Mangione, Carol M.
- Sadeghi, Banafsheh
- Sarrafzadeh, Majid
- Tong, Kathleen
- Fonarow, Gregg C.
- Venue
- JAMA Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2016-03-01
- Volume
- 176
- Issue
- 3
- Pages
- 310
- ISSN
- 2168-6106 (ISSN-L)
- PMC
- PMC4827701
- OpenAlex
- W2273316012
- Cited by
- 695
- References
- 32
- Citations by year
- 2026: 44 · 2025: 61 · 2024: 63 · 2023: 80 · 2022: 79 · 2021: 94 · 2020: 81 · 2019: 40 · 2018: 57 · 2017: 75 · 2016: 21
- FWCI
- 53.07
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Robert Wood Johnson Foundation
- Sierra Health Foundation
- National Institutes of Health (UL1TR000124)
- Agency for Healthcare Research and Quality (R01HS019311)
- University of California, Los Angeles (UL1 TR000124)
- National Heart, Lung, and Blood Institute (RC2HL101811)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- heart failure, remote patient monitoring, care transitions, hospital readmission, older adults, health coaching, telephone follow-up, acute decompensated heart failure, mortality, quality of life, post-discharge care, nurse-led intervention, telemedicine
- MeSH terms
- Aged, Aged, 80 and over, Female, Heart Failure, Humans, Male, Middle Aged, Monitoring, Physiologic, Patient Discharge, Patient Readmission, Prospective Studies, Quality of Life, Research Design, Telemetry, Telephone, United States, Confounding Factors, Epidemiologic, Proportional Hazards Models, Odds Ratio
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