Abstract 11007: Evaluating the Burden of Comorbidity on the Effect of Remote Noninvasive Tele-monitoring and Nurse Coaching for Patients With Heart Failure: A Secondary Analysis of the Beat-hf Trial

• Published in: Circulation (New York, N.Y.) N.Y.), 2019-11, Vol.140 (Suppl_1 Suppl 1), p.A11007-A11007
• Main Authors: Kimchi, Asher, Aronow, Harriet U, Ni, Yu Ming, Ong, Michael K, Mirocha, James, Black, Jeanne T, Auerbach, Andrew D, Ganiats, Theodore G, Greenfield, Sheldon, Romano, Patrick S, Kedan, Ilan
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.140.suppl_1.11007

IntroductionNoninvasive Telemonitoring (NTM) for patients with Heart Failure (HF) is a promising post-discharge treatment strategy, but studies have seen mixed results. Co-morbid conditions and disease burden influence health outcomes and are readily measurable in patients with HF. We hoped to identify HF patient subgroups based on the burden of comorbidity (CM) that may benefit from post-discharge NTM.MethodsThe Better Effectiveness After Transition - Heart Failure (BEAT-HF), a RCT with null effects, included 1404 patients randomized to six months of post-discharge NTM and nurse counseling (n=715) or usual HF care (n=722). The intervention included daily wireless transmission of vital signs and 3 rotating health questions along with nurse telephone coaching on a regular basis and in response to NTM triggers. For this analysis, a CM measure was calculated using complication/coexisting diagnoses (CCs) from index admissions to identify three subgroups with increasing burden of CM. Intervention effects evaluated 30-day and 180-day re-admissions, mortality, and combined days alive and out of hospital.ResultsThe sample averaged 5.7 CCs (SD = 2.4; range 0-16). CM subgroups identifiedLow (0-2 CC), n=110 (8.0%); Moderate (3-8 CC), n=1102 (80.3%); and High (9+ CC), n=160 (11.7%). Subgroups of higher burden had increased 30-day readmission (χ=19.4, p