I chose this question and the health promotion theory for my research. My research shows that this is an extremely relevant subject. Heart disease is the leading cause of death in the U.S. (Kochanek, et al., 2019). Furthermore, heart failure constitutes a significant healthcare burden, which includes mortality, hospitalizations, and associated costs (Jackson, et al., 2018). Re-hospotalization is a significant issue, with 24.7% of patients being readmitted within 30 days of discharge (Al-Khazaali, et al., 2016). A significant percentage of these re-hospitalizations could be avoided, saving $903 million (Al-Khazaali, et al., 2016). Therefore, developing and implementing measures aimed at reducing this re-hospitalization rates can contribute to a significant improvement in patient outcomes and a reduction in healthcare burden and spending on heart failure, including CHF.
Several effective strategies towards reducing re-hospitalization among patients with heart failure have been outlined. These include such surgical interventions as ultrafiltration and implanted left ventricular assist devices, addressing comorbidities, patient-related and health service-related factors, and home monitoring (Al-Khazaali, et al., 2016). An important factor outlined in the causes of re-hospitalization, particularly in elderly patients and those of a lower socioeconomic standing, is “nonadherence to drugs, diets, self-monitoring, and communication with the health care providers” (Al-Khazaali, et al., 2016, p. e802). This factor can be addressed by promoting healthy practices and helping the patient adhere to them.
In-home monitoring can be used to achieve these improvements and increasing outpatient oversight. Al-Khazaali, et al. (2016) explains that in-home monitoring is comprised of structured telephone support or telemonitoring, which physiological data is collected and transferred through a technological device. The results of previous studies are inconclusive results: some found no significant change when using either in-home monitoring method, while others reported a significant improvement (Al-Khazaali, et al., 2016). These controversial results, and the fact that home monitoring is a relatively new research subject, demonstrate that the current body of research is insufficient. The author recommends further research, including “a largemulticenter randomized clinical trial… toc onfirm the clinical implication of all the previously studied methods in reducing HF readmissions and generate universal protocols for all hospitals” (Al-Khazaali et al., 2016, p. E803). In-home monitoring for patients with heart failure is a promising subject that currently lacks the evidence required for implementation.
References
- Al-Khazaali, A., Arora, R., & Helu, H. K. (2016). Effective strategies in reducing rehospitalizations in patients with heart failure. American Journal of Therapeutics, 23(3), e799-e804. doi:10.1097/mjt.0000000000000065
- Jackson, S. L., Tong, X., King, R. J., Loustalot, F., Hong, Y., & Ritchey, M. D. (2018). National Burden of Heart Failure Events in the United States, 2006 to 2014. Circulation: Heart Failure, 11(12). doi:10.1161/circheartfailure.117.004873
- Kochanek, K. D., Murphy, S. L., Xu, J., & Arias, E. (2019). Deaths: Final data for 2017. National Vital Statistics Reports, 68(8). Web.