Telemonitoring for health education and self-management in South Western Sydney
Josephine Sau Fan Chow
A B C D E * , Amanda Sykes A , Joyce De Guzman A , Vicki Bonfield A and Nutan Maurya A
A South Western Sydney Local Health District, Sydney, NSW, Australia.
B Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.
C University of Sydney, Sydney, NSW, Australia.
D University of New South Wales, Sydney, NSW, Australia.
E Western Sydney University, Sydney, NSW, Australia.
Australian Journal of Primary Health 29(5) 490-500 https://doi.org/10.1071/PY22067
Submitted: 21 March 2022 Accepted: 12 February 2023 Published: 14 March 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University
Abstract
Background: Telemonitoring (TM) plays an important role in the self-management of chronic diseases. This study aimed to assess the feasibility of TM in early stages of chronic care for self-management and recognition of signs and symptoms of exacerbation, with a view to completing the TM program in an optimal timeframe to encourage independence and self-management.
Methods: This study was conducted from 2019 to 2020. Included in the study were patients with chronic conditions at an early stage of their disease residing in the South Western Sydney region. Eligible patients were allocated a TM device for 6 months. Their routine tests data were sent in real time to health care professionals. Following assessment by a TM coordinator, suitable patients were off-boarded (deactivation of monitoring device) after 6 months. Data on hospitalisation/emergency department presentation and surveys were collected to assess the impact of TM on the level of the patient’s understanding of their signs and symptoms of exacerbation, self-care, and quality of life.
Results: Out of 44 patients approached, seven were off-boarded at the 6-month timeframe. The follow-up data on the hospitalisation/emergency department presentation during monitoring and 12 months post off-boarding showed a reduction in the frequency of hospitalisation/nil admissions. Patients reported an increased understanding of their health condition and confidence in managing their own health with the support of TM.
Conclusion: The result demonstrates the feasibility of TM as a tool for health education and self-management in the coordination of care for chronic disease patients; however, the small sample size was a limitation.
Keywords: chronic diseases, community nursing, hospitalisation, model of care, off-boarded, self-management, telemonitoring, virtual care.
References
Celler B, Varnfield M, Nepal S, Sparks R, Li J, Jayasena R (2017) Impact of at-home telemonitoring on health services expenditure and hospital admissions in patients with chronic conditions: before and after control intervention analysis. JMIR Medical Informatics 5, e29| Impact of at-home telemonitoring on health services expenditure and hospital admissions in patients with chronic conditions: before and after control intervention analysis.Crossref | GoogleScholarGoogle Scholar |
Chatwin M, Hawkins G, Panicchia L, et al. (2016) Randomised crossover trial of telemonitoring in chronic respiratory patients (TeleCRAFT trial). Thorax 71, 305–311.
| Randomised crossover trial of telemonitoring in chronic respiratory patients (TeleCRAFT trial).Crossref | GoogleScholarGoogle Scholar |
Chow JSF, Gonzalez-Arce VE, Knight A, Maurya N, Kohler F (2019) Learnings from implementing telemonitoring – the LITE study. Journal of Integrated Care 27, 346–356.
| Learnings from implementing telemonitoring – the LITE study.Crossref | GoogleScholarGoogle Scholar |
Chow JSF, Knight A, Disney A, et al. (2021) Understanding the general practice of telemonitoring integrated care: a qualitative perspective. Australian Journal of Primary Health 27, 364–370.
| Understanding the general practice of telemonitoring integrated care: a qualitative perspective.Crossref | GoogleScholarGoogle Scholar |
Ding H, Jayasena R, Chen SH, et al. (2020) The effects of telemonitoring on patient compliance with self-management recommendations and outcomes of the innovative telemonitoring enhanced care program for chronic heart failure: randomized controlled trial. Journal of Medical Internet Research 22, e17559
| The effects of telemonitoring on patient compliance with self-management recommendations and outcomes of the innovative telemonitoring enhanced care program for chronic heart failure: randomized controlled trial.Crossref | GoogleScholarGoogle Scholar |
Fairbrother P, Pinnock H, Hanley J, et al. (2013) Exploring telemonitoring and self-management by patients with chronic obstructive pulmonary disease: a qualitative study embedded in a randomized controlled trial. Patient Education and Counselling 93, 403–410.
| Exploring telemonitoring and self-management by patients with chronic obstructive pulmonary disease: a qualitative study embedded in a randomized controlled trial.Crossref | GoogleScholarGoogle Scholar |
Halcomb E, Purcell R, Hickman L, Smyth E (2016) Telemonitoring is acceptable amongst community dwelling older Australians with chronic conditions. Collegian 23, 383–390.
| Telemonitoring is acceptable amongst community dwelling older Australians with chronic conditions.Crossref | GoogleScholarGoogle Scholar |
Hanlon P, Daines L, Campbell C, McKinstry B, Weller D, Pinnock H (2017) Telehealth interventions to support self-management of long-term conditions: a systematic metareview of diabetes, heart failure, asthma, chronic obstructive pulmonary disease, and cancer. Journal of Medical Internet Research 19, e172
| Telehealth interventions to support self-management of long-term conditions: a systematic metareview of diabetes, heart failure, asthma, chronic obstructive pulmonary disease, and cancer.Crossref | GoogleScholarGoogle Scholar |
Kaambwa B, Bryan S, Jowett S, et al. (2014) Telemonitoring and self-management in the control of hypertension (TASMINH2): a cost-effectiveness analysis. European Journal of Preventive Cardiology 21, 1517–1530.
| Telemonitoring and self-management in the control of hypertension (TASMINH2): a cost-effectiveness analysis.Crossref | GoogleScholarGoogle Scholar |
Kruse C, Pesek B, Anderson M, Brennan K, Comfort H (2019) Telemonitoring to manage chronic obstructive pulmonary disease: systematic literature review. JMIR Medical Informatics 7, e11496
| Telemonitoring to manage chronic obstructive pulmonary disease: systematic literature review.Crossref | GoogleScholarGoogle Scholar |
Li X, Xie Y, Zhao H, Zhang H, Yu X, Li J (2020) Telemonitoring interventions in COPD patients: overview of systematic reviews. BioMed Research International 2020, 5040521
| Telemonitoring interventions in COPD patients: overview of systematic reviews.Crossref | GoogleScholarGoogle Scholar |
Martín-Lesende I, Orruño E, Mateos M, et al. (2017) Telemonitoring in-home complex chronic patients from primary care in routine clinical practice: Impact on healthcare resources use. European Journal of General Practice 23, 135–142.
| Telemonitoring in-home complex chronic patients from primary care in routine clinical practice: Impact on healthcare resources use.Crossref | GoogleScholarGoogle Scholar |
McLean S, Nurmatov U, Liu JLY, Pagliari C, Car J, Sheikh A (2012) Telehealthcare for chronic obstructive pulmonary disease: Cochrane Review and meta-analysis. British Journal of General Practice 62, e739–e749.
| Telehealthcare for chronic obstructive pulmonary disease: Cochrane Review and meta-analysis.Crossref | GoogleScholarGoogle Scholar |
Monahan M, Jowett S, Nickless A, et al. (2019) Cost-effectiveness of telemonitoring and self-monitoring of blood pressure for antihypertensive titration in primary care (TASMINH4). Hypertension 73, 1231–1239.
| Cost-effectiveness of telemonitoring and self-monitoring of blood pressure for antihypertensive titration in primary care (TASMINH4).Crossref | GoogleScholarGoogle Scholar |
Morton K, Dennison L, May C, et al. (2017) Using digital interventions for self-management of chronic physical health conditions: a meta-ethnography review of published studies. Patient Education and Counselling 100, 616–635.
| Using digital interventions for self-management of chronic physical health conditions: a meta-ethnography review of published studies.Crossref | GoogleScholarGoogle Scholar |
Odeh B, Kayyali R, Nabhani-Gebara S, Philip N, Robinson P, Wallace CR (2015) Evaluation of a telehealth service for COPD and HF patients: clinical outcome and patients’ perceptions. Journal of Telemedicine and Telecare 21, 292–297.
| Evaluation of a telehealth service for COPD and HF patients: clinical outcome and patients’ perceptions.Crossref | GoogleScholarGoogle Scholar |
Omboni S, McManus RJ, Bosworth HB, et al. (2020) Evidence and recommendations on the use of telemedicine for the management of arterial hypertension: an international expert position paper. Hypertension 76, 1368–1383.
| Evidence and recommendations on the use of telemedicine for the management of arterial hypertension: an international expert position paper.Crossref | GoogleScholarGoogle Scholar |
Paré G, Jaana M, Sicotte C (2007) Systematic review of home telemonitoring for chronic diseases: the evidence base. Journal of the American Medical Informatics Association: JAMIA 14, 269–277.
| Systematic review of home telemonitoring for chronic diseases: the evidence base.Crossref | GoogleScholarGoogle Scholar |
Seto E (2008) Cost comparison between telemonitoring and usual care of heart failure: a systematic review. Telemedicine and e-Health 14, 679–686.
| Cost comparison between telemonitoring and usual care of heart failure: a systematic review.Crossref | GoogleScholarGoogle Scholar |
Steventon A, Bardsley M, Billings J, et al. (2012) Effect of telehealth on use of secondary care and mortality: findings from the Whole System Demonstrator cluster randomised trial. BMJ 344, e3874
| Effect of telehealth on use of secondary care and mortality: findings from the Whole System Demonstrator cluster randomised trial.Crossref | GoogleScholarGoogle Scholar |
Wade R, Cartwright C, Shaw K (2015) Carers’ perceptions of the impact of home telehealth monitoring on the provision of care and sustainability of use. Australasian Journal on Ageing 34, 109–114.
| Carers’ perceptions of the impact of home telehealth monitoring on the provision of care and sustainability of use.Crossref | GoogleScholarGoogle Scholar |
Walkden JA, McCullagh PJ, Kernohan WG (2019) Patient and carer survey of remote vital sign telemonitoring for self-management of long-term conditions. BMJ Health & Care Informatics 26, e100079
| Patient and carer survey of remote vital sign telemonitoring for self-management of long-term conditions.Crossref | GoogleScholarGoogle Scholar |
Wu JR, Moser DK, Lennie TA, Burkhart PV (2008) Medication adherence in patients who have heart failure: a review of the literature. The Nursing clinics of North America 43, 133–153.
| Medication adherence in patients who have heart failure: a review of the literature.Crossref | GoogleScholarGoogle Scholar |
