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• W3205528342 abstract "BACKGROUND Heart failure (HF) is responsible for a significant amount of the economic and chronic disease burden, which impacts the Canadian health system. The Ontario Telemedicine Network Telehomecare (THC) program, a home self-management initiative, was created to improve access to care and limit healthcare utilization. This study aimed to evaluate the impact of THC on HF patients’ health-related quality of life (HRQoL), disease-management skills, and satisfaction with the program; caregiver strain; and nurse satisfaction with THC. METHODS AND RESULTS This was a prospective longitudinal cohort study, including HF patients enrolled in Ontario's THC program, their informal caregivers and THC nurses. Participants were recruited across eight Local Health Integration Networks in Ontario. Patients and caregivers were administered telephone surveys at Baseline, Month 3, 6 and 12 follow-ups. Nurses who were delivering THC at the time of the evaluation were approached to participate in surveys. Surveys were administered between July 2016 and December 2019. The outcomes for the longitudinal surveys were patient HRQoL measured by Minnesota living with HF (MLHF), SF-12, and EQ-5D; disease-management skills; perception and satisfaction with THC; and caregiver perceived strain. Cross-sectional surveys were conducted to assess nurse perception and satisfaction with THC. Participant data were analyzed using general linear mixed models in SAS 9.4. One-hundred seventeen HF patients (65 men), 62 caregivers (11 men) and 24 nurses were surveyed, with an overall response rate of 51%. The average age of the patients was 71-11 years. Overall HF patients reported high levels of satisfaction, moderate disease management skills and perceived THC well. After adjusting for age and gender MLHF HRQoL scores significantly improved over time in the Overall, Physical and Emotional domains (P < .0001). Women with HF were shown to have worse HRQoL scores than men at the beginning of the study but had a greater improvement in health scores over the study period (P = 0.02). As HF patient's age increased in years THC perception and satisfaction with services were significantly lower (P = 0.002). Caregivers’ strain indexes decreased throughout the program, while nurses were satisfied with THC. CONCLUSION THC has been well received by HF patients and has been found to be an intervention with a lot of promise in terms of improving their HRQoL. However, the long-term sustainability of HRQoL improvements in HF patients requires further investigation. THC may assist in the management of HF across Ontario by giving patients more access to care that fits their needs. Heart failure (HF) is responsible for a significant amount of the economic and chronic disease burden, which impacts the Canadian health system. The Ontario Telemedicine Network Telehomecare (THC) program, a home self-management initiative, was created to improve access to care and limit healthcare utilization. This study aimed to evaluate the impact of THC on HF patients’ health-related quality of life (HRQoL), disease-management skills, and satisfaction with the program; caregiver strain; and nurse satisfaction with THC. This was a prospective longitudinal cohort study, including HF patients enrolled in Ontario's THC program, their informal caregivers and THC nurses. Participants were recruited across eight Local Health Integration Networks in Ontario. Patients and caregivers were administered telephone surveys at Baseline, Month 3, 6 and 12 follow-ups. Nurses who were delivering THC at the time of the evaluation were approached to participate in surveys. Surveys were administered between July 2016 and December 2019. The outcomes for the longitudinal surveys were patient HRQoL measured by Minnesota living with HF (MLHF), SF-12, and EQ-5D; disease-management skills; perception and satisfaction with THC; and caregiver perceived strain. Cross-sectional surveys were conducted to assess nurse perception and satisfaction with THC. Participant data were analyzed using general linear mixed models in SAS 9.4. One-hundred seventeen HF patients (65 men), 62 caregivers (11 men) and 24 nurses were surveyed, with an overall response rate of 51%. The average age of the patients was 71-11 years. Overall HF patients reported high levels of satisfaction, moderate disease management skills and perceived THC well. After adjusting for age and gender MLHF HRQoL scores significantly improved over time in the Overall, Physical and Emotional domains (P < .0001). Women with HF were shown to have worse HRQoL scores than men at the beginning of the study but had a greater improvement in health scores over the study period (P = 0.02). As HF patient's age increased in years THC perception and satisfaction with services were significantly lower (P = 0.002). Caregivers’ strain indexes decreased throughout the program, while nurses were satisfied with THC. THC has been well received by HF patients and has been found to be an intervention with a lot of promise in terms of improving their HRQoL. However, the long-term sustainability of HRQoL improvements in HF patients requires further investigation. THC may assist in the management of HF across Ontario by giving patients more access to care that fits their needs." @default.
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• W3205528342 title "THE IMPACT OF TELEHOMECARE ON HEART FAILURE PATIENTS, NURSES, AND INFORMAL CAREGIVERS: A LONGITUDINAL COHORT STUDY" @default.
• W3205528342 doi "https://doi.org/10.1016/j.cjca.2021.07.124" @default.
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