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Telemonitoring is acceptable amongst community dwelling older Australians with chronic conditions

Published:October 24, 2015DOI:https://doi.org/10.1016/j.colegn.2015.09.007

      Summary

      Background

      Telemonitoring is an innovative model of care being implemented to address the growing burden of chronic and complex disease.

      Objectives

      This paper explores the perceptions of community dwelling older people with chronic and complex conditions towards a general practice nurse-led telemonitoring intervention.

      Method

      A pre-test post-test intervention study was conducted with consumer surveys administered before and after the intervention. The telemonitoring intervention consisted of a period of home monitoring during which daily vital signs and symptoms were transmitted to the general practice nurse.

      Results

      21 participants completed both pre and post-test surveys. There was a significant difference between pre and post ratings on the survey item “the use of telemonitoring equipment seems difficult to me” (p = 0.013), and “telemonitoring will be a standard way of health care delivery in the future” (p = 0.032). Approximately half of the participants reported that telemonitoring provided them with a sense of security and peace of mind, assisted them to manage their health, in addition to improving their confidence in managing their care. Most participants felt more involved and expressed that daily monitoring helped them to understand changes in their condition.

      Conclusion

      Telemonitoring is acceptable to Australian community dwelling older persons with chronic conditions. Prior experience with computers and technology may not be a meditating factor in acceptability. The use of telemonitoring not only provided important physiological information to health professionals but also has the potential to empower older people by allowing them to better understand their own health.

      Keywords

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      References

        • Agarwal R.
        • Bills J.E.
        • Hecht T.J.
        • Light R.P.
        Role of home blood pressure monitoring in overcoming therapeutic inertia and improving hypertension control: A systematic review and meta-analysis.
        Hypertension. 2011; 57: 29-38https://doi.org/10.1161/HYPERTENSIONAHA.110.160911
      1. American Telemedicine Association. (2012). Telemedicine nomenclature. Retrieved from http://www.americantelemed.org/resources/nomenclature#T.

        • Artinian N.T.
        Telehealth as a tool for enhancing care for patients with cardiovascular disease.
        The Journal of Cardiovascular Nursing. 2007; 22: 25-31
        • Australian Institute of Health Welfare
        Australia's health 2014.
        Australia's health series. Vol. 14. Canberra, 2014
        • Bakken S.
        • Grullon-Figueroa L.
        • Izquierdo R.
        • Lee N.-J.
        • Morin P.
        • Palmas W.
        • et al.
        Development Validation, and Use of English and Spanish Versions of the Telemedicine Satisfaction and Usefulness Questionnaire. 2006; 13
        • Barlow J.
        • Wright C.
        • Sheasby J.
        • Turner A.
        • Hainsworth J.
        Self-management approaches for people with chronic conditions: A review.
        Patient Education and Counseling. 2002; 48: 177-187
        • Bauer U.E.
        • Briss P.A.
        • Goodman R.A.
        • Bowman B.A.
        Prevention of chronic disease in the 21st century: Elimination of the leading preventable causes of premature death and disability in the USA.
        Lancet. 2014; 384: 45-52https://doi.org/10.1016/S0140-6736(14)60648-6
        • Bonsaksen T.
        • Lerdal A.
        • Fagermoen M.S.
        Factors associated with self-efficacy in persons with chronic illness.
        Scandinavian Journal of Psychology. 2012; 53: 333-339https://doi.org/10.1111/j. 1467-9450.2012.00959.x
        • Clark R.A.
        • Inglis S.C.
        • McAlister F.A.
        • Cleland J.G.
        • Stewart S.
        Telemonitoring or structured telephone support programmes for patients with chronic heart failure: Systematic review and meta-analysis.
        BMJ. 2007; 334: 942
        • Conway A.
        • Inglis S.C.
        • Chang A.M.
        • Horton-Breshears M.
        • Cleland J.G.
        • Clark R.A.
        Not all systematic reviews are systematic: A meta-review of the quality of systematic reviews for non-invasive remote monitoring in heart failure.
        Journal of Telemedicine and Telecare. 2013; 19: 326-337https://doi.org/10.1177/1357633x13503427
        • Corbin J.M.
        • Strauss A.
        A nursing model for chronic illness management based upon the trajectory framework.
        Research and Theory for Nursing Practice. 1991; 5: 155-174
        • Cross R.K.
        • Finkelstein J.
        Feasibility and acceptance of a home telemanagement system in patients with inflammatory bowel disease: A 6-month pilot study.
        Digestive Diseases and Sciences. 2007; 52: 357-364https://doi.org/10.1007/s10620-006-9523-4
        • Disler T.R.
        • Inglis C.S.
        • Newton J.P.
        • Currow C.D.
        • Macdonald S.P.
        • Glanville R.A.
        • et al.
        Patterns of technology use in patients attending a cardiopulmonary outpatient clinic: A self-report survey.
        Interactive Journal of Medical Research. 2015; 4: e5https://doi.org/10.2196/ijmr.3955
        • Ekeland A.G.
        • Bowes A.
        • Flottorp S.
        Effectiveness of telemedicine: A systematic review of reviews.
        International Journal of Medical Informatics. 2010; 79: 736-771https://doi.org/10.1016/j.ijmedinf.2010.08.006
        • Finkelstein J.
        • Cabrera M.R.
        • Hripcsak G.
        Internet-based home asthma telemonitoring: Can patients handle the technology?.
        Chest. 2000; 117: 148-155
        • Finkelstein J.
        • Khare R.
        • Ansell J.
        Feasibility and patients’ acceptance of Home Automated Telemanagement of oral anticoagulation therapy.
        AMIA Annual Symposium Proceedings/AMIA Symposium. AMIA Symposium. 2003; : 230-234
        • Glasgow R.E.
        • Toobert D.J.
        • Hampson S.E.
        • Brown J.E.
        • Lewinsohn P.M.
        • Donnelly J.
        Improving self-care among older patients with type II diabetes: Thethe “Sixty Something…” study.
        Patient Education and Counseling. 1992; 19: 61-74https://doi.org/10.1016/0738-3991(92)90102-O
        • Golant S.M.
        Aging in place solutions for older Americans: Groupthink responses not always in their best interests.
        Public Policy & Aging Report. 2009; 19: 1-39https://doi.org/10.1093/ppar/19.1.1
        • Harahan M.
        • Sanders A.
        • Stone R.
        Creating new longterm care choices for older adults: A synthesis of findings from a study of affordable housing plus services linkages.
        Institute for the Future of Aging Services (IFAS), American Association of Homes and Services for the Aging (AAHSA), 2006
        • Hendrik Schäfer H.
        • Sudano I.
        • Theus G.-R.
        • Noll G.
        • Burnier M.
        Target blood pressure attainment with antihypertensive therapy in Swiss primary care.
        Blood Pressure. 2012; 21: 211-219
        • Inglis S.C.
        • Clark R.A.
        • Cleland J.G.
        • McAlister F.
        • Stewart S.
        Structured telephone support or telemonitoring programs for patients with chronic heart failure.
        The Cochrane Library. 2008;
        • Inglis S.C.
        • Clark R.A.
        • McAlister F.A.
        • Stewart S.
        • Cleland J.G.
        Which components of heart failure programmes are effective? A systematic review and meta-analysis of the outcomes of structured telephone support or telemonitoring as the primary component of chronic heart failure management in 8323 patients: Abridged Cochrane Review.
        European Journal of Heart Failure. 2011; 13: 1028-1040https://doi.org/10.1093/eurjhf/hfr039
        • Jerant A.F.
        • Azari R.
        • Martinez C.
        • Nesbitt T.S.
        A randomized trial of telenursing to reduce hospitalization for heart failure: Patient-centered outcomes and nursing indicators.
        Home Health Care Services Quarterly. 2003; 22: 1-20https://doi.org/10.1300/J027v22n01_01
        • Lee J.
        • Rho M.J.
        Perception of influencing factors on acceptance of mobile health monitoring service: A comparison between users and non-users.
        Healthcare Information Research. 2013; 19: 167-176
        • Louis A.A.
        • Turner T.
        • Gretton M.
        • Baksh A.
        • Cleland J.G.
        A systematic review of telemonitoring for the management of heart failure.
        European Journal of Heart Failure. 2003; 5: 583-590
        • Mallen C.D.
        Osteoarthritis the forgotten chronic disease. Time for a multimorbid approach?.
        European Journal of General Practice. 2012; 18: 131-132https://doi.org/10.3109/13814788.2012.714362
        • New South Wales Department of Health
        Improving care for people with chronic disease: A practical toolkit for clinicians and managers.
        NSW Dept. of Health, North Sydney, NSW2005
        • Nimmon L.
        • Poureslami I.
        • FitzGerald M.
        Telehealth interventions for management of chronic obstructive lung disease (COPD) and asthma: A critical review.
        International Journal of Healthcare Information Systems and Informatics (IJHISI). 2013; 8: 37-56https://doi.org/10.4018/jhisi.2013010103
        • Odeh B.
        • Kayyali R.
        • Nabhani-Gebara S.
        • Philip N.
        • Robinson P.
        • Wallace C.R.
        Evaluation of a Telehealth Service for COPD and HF patients: Clinical outcome and patients’ perceptions.
        Journal of Telemedicine and Telecare. 2015; (1357633X15574807)
        • Omboni S.
        • Guarda A.
        Impact of home blood pressure telemonitoring and blood pressure control: A meta-analysis of randomized controlled studies.
        American Journal of Hypertension. 2011; 24: 989-998https://doi.org/10.1038/ajh.2011.100
        • Pare G.
        • Moqadem K.
        • Pineau G.
        • St-Hilaire C.
        Clinical effects of home telemonitoring in the context of diabetes, asthma, heart failure and hypertension: A systematic review.
        Journal of Medical Internet Research. 2010; 12: e21
        • Purcell R.
        • McInnes S.
        • Halcomb E.J.
        Telemonitoring can assist in managing cardiovascular disease in primary care: A systematic review of systematic reviews.
        BMC Family Practice. 2014; 15 (URL: http://www.biomedcentral.com/1471-2296/1415/1443)https://doi.org/10.1186/1471-2296-15-43
        • Stewart S.
        • Horowitz J.D.
        Detecting early clinical deterioration in chronic heart failure patients post-acute hospitalisation-a critical component of multidisciplinary, home-based intervention?.
        European Journal of Heart Failure. 2002; 4: 345-351
        • Stone R.A.
        • Sevick M.A.
        • Rao R.H.
        • Macpherson D.S.
        • Cheng C.
        • Kim S.
        • et al.
        The Diabetes Telemonitoring Study Extension: An exploratory randomized comparison of alternative interventions to maintain glycemic control after withdrawal of diabetes home telemonitoring.
        Journal of the American Medical Informatics Association. 2012; 19: 973-979https://doi.org/10.1136/amiajnl-2012-000815
        • Venkatesh V.
        • Thong J.Y.
        • Xu X.
        Consumer acceptance and use of information technology: Extending the unified theory of acceptance and use of technology.
        MIS Quarterly. 2012; 36: 157-178
        • WHO
        Global status report on noncommunicable diseases 2010.
        World Health Organization, Geneva, Switzerland2011
        • Yach D.
        • Hawkes C.
        • Gould C.L.
        • Hofman K.J.
        The global burden of chronic diseases: Overcoming impediments to prevention and control.
        JAMA: The Journal of the American Medical Association. 2004; 291: 2616-2622https://doi.org/10.1001/jama.291.21.2616
        • Yu D.S.F.
        • Thompson D.R.
        • Lee D.T.F.
        Disease management programmes for older people with heart failure: Crucial characteristics which improve post-discharge outcomes.
        European Heart Journal. 2006; 27: 596-612https://doi.org/10.1093/eurheartj/ehi656