New research from the Smidt Heart Institute at Cedars-Sinai in Los Angeles finds that check-in calls may help save lives.
“There’s a lot of new technology and new ideas about how to manage people who have heart failure remotely, but we demonstrated that low-tech and old-fashioned talking on the phone, essentially monitoring the response to, ‘How are you feeling?’ can improve outcomes,” said corresponding study author Dr. Ilan Kedan, a professor of cardiology at the institute.
About one-third of people die within a year of being hospitalized for heart failure, a condition in which the heart does not pump enough blood to support the organs. About 15% to 20% of heart failure patients who were hospitalized return to the hospital within 30 days, according to past research.
To study the impact of phone calls on outcomes, the researchers included just over 1,300 patients aged 50 or older who were hospitalized for acute heart failure between October 2011 and September 2013 at six academic medical centers in California.
Half of the patients were randomized to receive a new post-hospitalization care plan.
In this new plan, patients were given a blood pressure monitor and a scale. The patients received pre-discharge heart failure education, along with an average of five calls over a 180-day period during which nurses asked about weight, blood pressure, heart rate and any unusual symptoms.
Patients who reported abnormal results or symptoms received more follow-up calls.
The other half of the study participants received usual care, including a nurse educating them about heart failure before being discharged and, for most patients, one call from the hospital after returning home.
The investigators also grouped patients based on the number of other health conditions they had (“comorbidities”), ranging from zero to nine or more.
Patients categorized in the grouping with the highest number of other conditions who were also in the intervention group were 25% less likely to die at 30 days and 180 days than patients in the control group. Those in this group also stayed out of the hospital a mean of 152 days versus a mean of 133 days for the patients who did not receive the intervention.
Patients in the groups with low or moderate other health conditions who received more frequent calls did not have any statistically significant different outcomes than the patients who only received one phone call. Readmission rates were similar for both the intervention and control groups, according to the study.
“What makes this study unique is our methodology, how we grouped people according to the number of comorbidities they had,” Kedan said in a Cedars-Sinai news release. “Investigators may consider using a similar approach to identify which patients may benefit the most from heart failure interventions.”
This is considered a practical solution for those who might struggle using a smartphone app or computer-based program.
The findings were published online recently in the Journal of Cardiac Failure.
The American Heart Association has more on heart failure.
SOURCE: Cedars-Sinai Los Angeles, news release, Jan. 31, 2023