The effect of tablet computer-based telemonitoring added to an established telephone disease management program on heart failure hospitalizations: The Specialized Primary and Networked Care in Heart Failure (SPAN-CHF) III Randomized Controlled Trial.

BACKGROUND: Mobile health applications are becoming increasingly common. Prior work has demonstrated reduced HF hospitalizations with HF disease management programs; however, few of these programs have used tablet computer-based technology.

METHODS: Participants with a diagnosis of HF and at least one high risk feature for hospitalization were randomized to either an established telephone-based disease management program or the same disease management program with the addition of remote monitoring of weight, blood pressure, heart rate and symptoms via a tablet computer for 90 days. The primary endpoint was the number of days hospitalized for HF assessed at 90 days.

RESULTS: From August 2014 to April 2019, 212 participants from three hospitals in Massachusetts were randomized 3:1 to telemonitoring-based HF disease management (n=159) or telephone-based HF disease management (n=53) with 98% of individuals in both study groups completing the 90 days of follow-up. There was no significant difference in the number of days hospitalized for HF between the telemonitoring disease management group (0.88±3.28 days per patient-90 days) and the telephone-based disease management group (1.00±2.97 days per patient-90 days); incidence rate ratio 0.82 (95% confidence interval [CI], 0.43 to 1.58; p=0.442).

CONCLUSIONS: The addition of tablet-based telemonitoring to an established heart failure telephone-based disease management program did not reduce HF hospitalizations; however, study power was limited REGISTRATION: ClinicalTrials.gov, NCT02084992. Registered on 10 March 2014.