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activation, heart failure, quality of life, remote monitoring systems, self-care



  1. Evangelista, Lorraine S. PhD, RN, FAHA, FAAN
  2. Lee, Jung-Ah PhD, RN
  3. Moore, Alison A. MD, MPH
  4. Motie, Marjan PhD
  5. Ghasemzadeh, Hassan PhD
  6. Sarrafzadeh, Majid PhD
  7. Mangione, Carol M. MD, MSPH


Background: The use of remote monitoring systems (RMSs) in healthcare has grown exponentially and has improved the accessibility to and ability of patients to engage in treatment intensification. However, research describing the effects of RMSs on activation, self-care, and quality of life (QOL) in older patients with heart failure (HF) is limited.


Objective: The aim of this study was to compare the effects of a 3-month RMS intervention on activation, self-care, and QOL of older patients versus a reference group matched on age, gender, race, and functional status (ie, New York Heart Association classification) who received standard discharge instructions after an acute episode of HF exacerbation requiring hospitalization.


Methods: A total of 21 patients (mean age, 72.7 +/- 8.9 years; range, 58-83 years; 52.4% women) provided consent and were trained to measure their weight, blood pressure, and heart rate at home with an RMS device and transmit this information every day for 3 months to a centralized information system. The system gathered all data and dispatched alerts when certain clinical conditions were met.


Results: The baseline sociodemographic and clinical characteristics of the 2 groups were comparable. Over time, participants in the RMS group showed greater improvements in activation, self-care, and QOL compared with their counterparts. Data showed moderately strong associations between increased activation, self-care, and QOL.


Conclusion: Our preliminary data show that the use of an RMS is feasible and effective in promoting activation, self-care, and QOL. A larger-scale randomized clinical trial is warranted to show that the RMS is a new and effective method for improving clinical management of older adults with chronic HF.