Hariyono Hariyono, Sri Pantja Madyawati, Leo Yosdimyati Romli, Chin Xuan Tan, Shifa Fauziyah, Teguh Hari Sucipto

Telemonitoring-Based Cardiac Care to Reduce Readmissions in Coronary Heart Disease Patients

Introduction

Telemonitoring-based cardiac care to reduce readmissions in coronary heart disease patients. Discover how integrated telemonitoring-based cardiac care, with educational support and follow-up, significantly reduces hospital readmissions for Coronary Heart Disease (CHD) patients.

Abstract

Coronary heart disease (CHD) continues to be a leading cause of hospital readmissions, especially among elderly individuals with low educational attainment and limited understanding of health information. This research aimed to evaluate how cardiac care management influences the frequency of hospital readmission in patients diagnosed with CHD. Employing a quasi-experimental method with a one-group pretest-posttest design, the study involved 100 participants at Jombang Hospital, chosen through purposive sampling. Information regarding readmission rates was gathered before and after the intervention using structured questionnaires and assessed through the Wilcoxon signed-rank test. Before receiving the intervention, 25% of patients had been readmitted more than twice, while none avoided readmission altogether. Following the management program, only 5% experienced multiple readmissions, and 25% reported none. The statistical outcome demonstrated a significant difference (p = 0.002), proving that cardiac care interventions consisting of educational support, family involvement, and consistent follow-up effectively decreased patient readmission. Most participants were aged between 61 and 75, male, and had only completed elementary school, all of which are factors associated with poor disease self-management. This trial confirms that integrated cardiac care management greatly improves the outcomes of recovery and decreases the risk of rehospitalization in CHD patients.

Review

This study addresses a crucial challenge in healthcare, focusing on the high rates of hospital readmission among Coronary Heart Disease (CHD) patients, particularly those from vulnerable demographics such as the elderly with lower educational attainment. Employing a quasi-experimental, one-group pretest-posttest design with 100 participants, the research aimed to evaluate the impact of a cardiac care management program at Jombang Hospital. The intervention, described as comprising educational support, family involvement, and consistent follow-up, demonstrated a statistically significant reduction in readmission rates (p = 0.002). Post-intervention, the proportion of patients with multiple readmissions dropped from 25% to 5%, and a quarter of patients avoided readmission entirely, indicating a positive immediate effect on patient recovery and outcomes. While the findings are promising and address a pertinent issue, several methodological considerations warrant attention. The quasi-experimental, one-group design, although practical for initial assessments, inherently limits the definitive attribution of observed improvements solely to the intervention due to the absence of a control group. This design makes it challenging to rule out other confounding factors or the natural course of recovery. A significant point of concern is the discrepancy between the study's title, "Telemonitoring-Based Cardiac Care," and the abstract's description of the intervention components, which detail educational support, family involvement, and consistent follow-up without explicitly elaborating on the role or nature of telemonitoring. This lack of detail makes it difficult to understand the specific mechanisms through which telemonitoring might have contributed, if at all, or if it was a component not fully explored in the abstract. Despite these limitations, the research offers valuable insights into effective strategies for reducing readmissions in a high-risk population where poor disease self-management is prevalent. The focus on integrated care, including educational support and family involvement, is commendable and aligns with best practices for chronic disease management. To strengthen future research in this area, adopting a more robust design, such as a randomized controlled trial, would enhance the internal validity and generalizability of the findings. Furthermore, a precise and detailed exposition of all intervention components, especially the specific "telemonitoring" aspects, would be crucial for replication and for guiding the development of more comprehensive and effective cardiac care programs.

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