IMPACT OF TELEHOMECARE PROGRAM ON MONITORING PARAMETERS AMONG COPD AND HF PATIENTS

Purpose:

   Telehomecare program was introduced as a patient self-management program in 2007.  There is inconclusive  data on the association of participation and patient-level outcomes. The purpose of this abstract is to report on patient monitoring parameters as a part of comprehensive evaluation of Telehomecare (THC) Program.  

Methods:

   The descriptive study evaluated overall patterns of use of the THC Program analyzing patients’ monitoring parameters such as blood pressure, oxygen levels and weight. The cohort included both chronic obstructive pulmonary disease (COPD) and heart failure (HF) patients enrolled in THC across Central West, North East and Toronto Central Local Health Integration Networks (LHINs) during the period of July 2012 to Mar 2015. Data was extracted from the OTN’s Patient Management Monitoring System (PMMS) database and analysed using repeated measures with a generalized linear mixed model procedures in SAS. We estimated whether the outcome measures were changing during participation in the Telehomecare Program.

Results:

   Overall 2470 patients enrolled and completed at least one month in the THC Program. Average age of participants was 74.5±11.2, 52% were women, and there was a  slight predominance of HF patients (n=1354; 54.8%). During the first month of enrollment one third of the patients (n=810) had elevated blood pressure (BP), with monthly average systolic BP of 150.2±9.5 mm Hg and average diastolic BP of 78.8±12.5, compared with adequately controlled (n=1660) patients, who had  mean systolic BP of 120.6±12.7 mm Hg and mean diastolic BP of 68.3±9.7 mm Hg. We found clinically and statistically significant reduction in systolic and diastolic blood pressure in initially hypertensive patients, over the seven-month program participation period when adjusted for age, gender and disease.  For systolic BP reduction was 10.8 mm Hg (95% CI 9.6-12.0) and diastolic BR reduction was 6.5 mm Hg (95% CI 5.6-7.3). Although not clinically meaningful, there was a statistically significant reduction in impaired oxygen saturation levels and weight fluctuations in program participants.  

Conclusion:

   The changes seen in patient  monitoring parameters over time, leads us to interpret that hypertensive patients may benefit the most from participating in the Program. This is regardless of their age, gender, disease  or geographical area. Further analyses are on the way to confirm these results.