Telephone support to rural and remote patients with heart failure: The chronic heart failure assessment by telephone (CHAT) study

Krum, H; Forbes, A; Yallop, J; Driscoll, A; Croucher, J; Chan, B; Clark, R; Davidson, P; Huynh, L; Kasper, EK; Hunt, D; Egan, H; Stewart, S; Piterman, L; Tonkin, A

Telephone support to rural and remote patients with heart failure: The chronic heart failure assessment by telephone (CHAT) study

Krum, H Forbes, A Yallop, J Driscoll, A Croucher, J Chan, B Clark, R Davidson, P

Huynh, L Kasper, EK Hunt, D Egan, H Stewart, S Piterman, L Tonkin, A

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Publication Type:: Journal Article
Citation:: Cardiovascular Therapeutics, 2013, 31 (4), pp. 230 - 237
Issue Date:: 2013-08-01

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Field	Value	Language
dc.contributor.author	Krum, H	en_US
dc.contributor.author	Forbes, A	en_US
dc.contributor.author	Yallop, J	en_US
dc.contributor.author	Driscoll, A	en_US
dc.contributor.author	Croucher, J	en_US
dc.contributor.author	Chan, B	en_US
dc.contributor.author	Clark, R	en_US
dc.contributor.author	Davidson, P https://orcid.org/0000-0003-2050-1534	en_US
dc.contributor.author	Huynh, L	en_US
dc.contributor.author	Kasper, EK	en_US
dc.contributor.author	Hunt, D	en_US
dc.contributor.author	Egan, H	en_US
dc.contributor.author	Stewart, S	en_US
dc.contributor.author	Piterman, L	en_US
dc.contributor.author	Tonkin, A	en_US
dc.date.issued	2013-08-01	en_US
dc.identifier.citation	Cardiovascular Therapeutics, 2013, 31 (4), pp. 230 - 237	en_US
dc.identifier.issn	1755-5914	en_US
dc.identifier.uri	http://hdl.handle.net/10453/26772
dc.description.abstract	Summary: Background: Heart failure (HF) remains a condition with high morbidity and mortality. We tested a telephone support strategy to reduce major events in rural and remote Australians with HF, who have limited healthcare access. Telephone support comprised an interactive telecommunication software tool (TeleWatch) with follow-up by trained cardiac nurses. Methods: Patients with a general practice (GP) diagnosis of HF were randomized to usual care (UC) or UC and telephone support intervention (UC+I) using a cluster design involving 143 GPs throughout Australia. Patients were followed up for 12 months. The primary endpoint was the Packer clinical composite score. Secondary endpoints included hospitalization for any cause, death or hospitalization, as well as HF hospitalization. Results: Four hundred and five patients were randomized to CHAT. Patients were well matched at baseline for key demographic variables. The primary endpoint of the Packer score was not different between the two groups (P = 0.98), although more patients improved with UC+I. There were fewer patients hospitalized for any cause (74 vs. 114, adjusted HR 0.67 [95% CI 0.50-0.89], P = 0.006) and who died or were hospitalized (89 vs. 124, adjusted HR 0.70 [95% CI 0.53-0.92], P = 0.011), in the UC+I vs. UC group. HF hospitalizations were reduced with UC+I (23 vs. 35, adjusted HR 0.81 [95% CI 0.44-1.38]), although this was not significant (P = 0.43). There were 16 deaths in the UC group and 17 in the UC+I group (P = 0.43). Conclusions: Although no difference was observed in the primary endpoint of CHAT (Packer composite score), UC+I significantly reduced the number of HF patients hospitalized among a rural and remote cohort. These data suggest that telephone support may be an efficacious approach to improve clinical outcomes in rural and remote HF patients. © 2012 John Wiley & Sons Ltd.	en_US
dc.relation.ispartof	Cardiovascular Therapeutics	en_US
dc.relation.isbasedon	10.1111/1755-5922.12009	en_US
dc.subject.classification	Cardiovascular System & Hematology	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Chronic Disease	en_US
dc.subject.mesh	Disease Progression	en_US
dc.subject.mesh	Treatment Outcome	en_US
dc.subject.mesh	Hospitalization	en_US
dc.subject.mesh	Proportional Hazards Models	en_US
dc.subject.mesh	Odds Ratio	en_US
dc.subject.mesh	Telemedicine	en_US
dc.subject.mesh	Time Factors	en_US
dc.subject.mesh	Telephone	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Rural Health Services	en_US
dc.subject.mesh	Health Services Accessibility	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Heart Failure	en_US
dc.subject.mesh	Kaplan-Meier Estimate	en_US
dc.title	Telephone support to rural and remote patients with heart failure: The chronic heart failure assessment by telephone (CHAT) study	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	31	en_US
utslib.for	1102 Cardiorespiratory Medicine and Haematology	en_US
utslib.for	1115 Pharmacology and Pharmaceutical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Nursing
utslib.copyright.status	closed_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	31	en_US

Abstract:

Summary: Background: Heart failure (HF) remains a condition with high morbidity and mortality. We tested a telephone support strategy to reduce major events in rural and remote Australians with HF, who have limited healthcare access. Telephone support comprised an interactive telecommunication software tool (TeleWatch) with follow-up by trained cardiac nurses. Methods: Patients with a general practice (GP) diagnosis of HF were randomized to usual care (UC) or UC and telephone support intervention (UC+I) using a cluster design involving 143 GPs throughout Australia. Patients were followed up for 12 months. The primary endpoint was the Packer clinical composite score. Secondary endpoints included hospitalization for any cause, death or hospitalization, as well as HF hospitalization. Results: Four hundred and five patients were randomized to CHAT. Patients were well matched at baseline for key demographic variables. The primary endpoint of the Packer score was not different between the two groups (P = 0.98), although more patients improved with UC+I. There were fewer patients hospitalized for any cause (74 vs. 114, adjusted HR 0.67 [95% CI 0.50-0.89], P = 0.006) and who died or were hospitalized (89 vs. 124, adjusted HR 0.70 [95% CI 0.53-0.92], P = 0.011), in the UC+I vs. UC group. HF hospitalizations were reduced with UC+I (23 vs. 35, adjusted HR 0.81 [95% CI 0.44-1.38]), although this was not significant (P = 0.43). There were 16 deaths in the UC group and 17 in the UC+I group (P = 0.43). Conclusions: Although no difference was observed in the primary endpoint of CHAT (Packer composite score), UC+I significantly reduced the number of HF patients hospitalized among a rural and remote cohort. These data suggest that telephone support may be an efficacious approach to improve clinical outcomes in rural and remote HF patients. © 2012 John Wiley & Sons Ltd.

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http://hdl.handle.net/10453/26772