Heart Failure Readmissions Similar After Telehealth, In-Person Follow-up

Follow-up visits via telemedicine were as effective at reducing 30-day readmission rates among heart failure patients as in-person follow-ups, according to a new study published in the Journal of the American Heart Association.

The study subjects were patients with heart failure residing in North Carolina. The goal of the study was to compare the differences in readmission rates between patients who received a follow-up in person, through telehealth, or did not receive one at all.

The study also aimed to determine the general effect the COVID-19 pandemic had on follow-up appointments and their setting, how telehealth related to patient demographics, and whether telehealth was more efficient than in-person appointments in reducing readmissions.

The sample included 6,918 patients. Overall, 46.3 percent of patients attended a follow-up appointment during the pandemic. Of this population, one out of six patients, or about 7.6 percent, participated in their appointment through telehealth.

Researchers found that 23 percent of patients who received no follow-up were readmitted within 30 days of discharge, significantly higher than the 14 percent who received in-person follow-up and the 15 percent of those who attended their follow-up appointment through telehealth.

Thus, patients who participated in early follow-ups, in general, were at a lower risk for readmission regardless of the setting, researchers observed.

In addition, the study showed that compared with patients without early follow‐up, those who received early follow‐up were younger, more likely to be Medicare beneficiaries, had more comorbidities, and were less likely to live in a disadvantaged neighborhood. But there were no significant differences in patient demographics regarding telehealth versus in-person follow-up.

But the study also had several limitations, including the single academic medical center setting, the lack of fully developed physiological information, the lack of detailed information on the characteristics of telemedicine, and the lack of information regarding missed appointments.

Despite the limitations, the "findings provide strong evidence for the use of telemedicine post-discharge to reduce the risks of 30‐day readmission," researchers concluded.

Follow-up visits are increasingly conducted via telehealth, and the potential benefits of the care modality are coming to light.

A recent study shows how telehealth increased access to follow-up visits for Black patients. According to Eric Bressman, MD, the lead author of the study and a fellow in the National Clinician Scholars Program, Black patients frequently miss follow-up appointments, but telehealth helped increase attendance. The preference for telehealth may be related to a reduction of racial care disparities, Bressman said. 

As telehealth use remains popular, providers are also trying to determine how and when to use the care modality while considering patient preferences.

For example, using telehealth along with in-person services to care for asthma met the preferences of many patients, according to a recent study. During the pandemic, asthma patients found that telehealth often made it easier to communicate, build trust, and maintain a positive relationship with a single provider rather than a team.