Remote Patient Monitoring Did Not Reduce Heart Failure Readmissions

While exploring ways to improve care for heart failure (HF) patients discharged from the hospital, a study published in JAMA Internal Medicine found that remote patient monitoring (RPM) had no beneficial effect on reducing hospitalization and mortality levels.

The goal of the study was to examine whether a remote patient monitoring program, which involved monitoring diuretic adherence and weight changes, resulted in a decrease in hospital readmissions or the death rate of previously hospitalized HF patients.

The study, known as the Electronic Monitoring of Patients Offers Ways to Enhance Recovery (EMPOWER), consisted of 552 participants, 290 of which were men. Seventy-five percent of patients were 80 percent adherent to medication and weight measurement every month.

Of the 552 patients in the study, 280 received usual care, and 272 received a compound RPM intervention. Those in the compound intervention group used digital scales and electronic pill bottles for diuretic medication. They also received lottery incentives that involved a payout conditional on adherence to the prescription and weight measurement of the previous day.

If bodyweight increased by more than 1.4 kg in 24 hours or 2.3 kg in 72 hours, or if there was abstinence from diuretic medication for more than five days, physicians received a notification.

To determine the effectiveness of each method, researchers assessed the time to death and readmission in the 12 months following treatment.

In the usual care group, there were 423 readmissions and 26 deaths. In the intervention group, there were 377 readmissions and 23 deaths. Participants in the intervention group were also slightly more likely to spend fewer days in the hospital.

But researchers reported similarities between the two groups regarding all-cause inpatient readmission and death.

Based on these results, researchers determined that EMPOWER did not significantly benefit HF patients. These results provide potential strategies to enhance RPM strategies in the future, according to researchers. 

Limitations of the study included a single academic health system setting and the selection of participants during a time of advancements in usual care.

Previous studies on RPM methods for treating chronic conditions have provided mixed results.

In September 2021, a Mayo Clinic study tested the effectiveness of an RPM model in treating COVID-19. The study placed patients into one of two RPM models based on risk factors. Researchers found both RPM models increased patient engagement, reduced hospitalization, and lowered mortality rates.

But another study, published in October 2021, showed that an RPM platform didn’t significantly affect the mortality rate or the rehospitalization rate among patients who had surgeries during the pandemic. Even then, RPM helped reduce pain among discharged patients.