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Heart Failure Telemonitoring in Japan and Sweden: A Cross-Sectional Survey
Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. University of Tokyo, Japan; Research Abroad, Japan.
Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0001-7431-2873
University of Tokyo, Japan.
University of Medical Centre Groningen, Netherlands.
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2015 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 17, no 11, e258- p.Article in journal (Refereed) PublishedText
Abstract [en]

Background: Telemonitoring of heart failure (HF) patients is increasingly discussed at conferences and addressed in research. However, little is known about actual use in specific countries. Objective: We aimed to (1) describe the use of non-invasive HF telemonitoring, (2) clarify expectations of telemonitoring among cardiologists and nurses, and (3) describe barriers to the implementation of telemonitoring in Japan and Sweden. Methods: This study used a cross-sectional survey of non-invasive HF telemonitoring. A total of 378 Japanese (120 cardiologists, 258 nurses) and 120 Swedish (39 cardiologists, 81 nurses) health care professionals from 165 Japanese and 61 Swedish hospitals/clinics nationwide participated in the study (210 in Japan and 98 in Sweden were approached). Data were collected between November 2013 and May 2014 with a questionnaire that was adapted from a previous Dutch study on telemonitoring. Results: The mean age of the cardiologists and nurses was 47 years and 41 years, respectively. Experience at the current position caring for HF patients was 19 years among the physicians and 15 years among the nurses. In total, 7 Japanese (4.2%) and none of the Swedish health care institutions used telemonitoring. One fourth (24.0%, 118/498) of the health care professionals were familiar with the technology (in Japan: 21.6%, 82/378; in Sweden: 30.0%, 36/120). The highest expectations of telemonitoring (rated on a scale from 0-10) were reduced hospitalizations (8.3 in Japan and 7.5 in Sweden), increased patient self-care (7.8 and 7.4), and offering high-quality care (7.8 and 7.0). The major goal for introducing telemonitoring was to monitor physical condition and recognize signs of worsening HF in Japan (94.1%, 352/374) and Sweden (88.7%, 102/115). The following reasons were also high in Sweden: to monitor effects of treatment and adjust it remotely (86.9%, 100/115) and to do remote drug titration (79.1%, 91/115). Just under a quarter of Japanese (22.4%, 85/378) and over a third of Swedish (38.1%, 45/118) health care professionals thought that telemonitoring was a good way to follow up stable HF patients. Three domains of barriers were identified by content analysis: organizational barriers "how are we going to do it?" (categories include structure and resource), health care professionals themselves "what do we need to know and do" (reservation), and barriers related to patients "not everybody would benefit" (internal and external shortcomings). Conclusions: Telemonitoring for HF patients has not been implemented in Japan or Sweden. However, health care professionals have expectations of telemonitoring to reduce patients hospitalizations and increase patient self-care. There are still a wide range of barriers to the implementation of HF telemonitoring.

Place, publisher, year, edition, pages
JMIR PUBLICATIONS, INC , 2015. Vol. 17, no 11, e258- p.
Keyword [en]
disease management; expectation; heart failure; implementation barriers; nurses; perception; physicians; telemedicine
National Category
Clinical Medicine Sociology
Identifiers
URN: urn:nbn:se:liu:diva-123823DOI: 10.2196/jmir.4825ISI: 000366179400012PubMedID: 26567061OAI: oai:DiVA.org:liu-123823DiVA: diva2:892883
Note

Funding Agencies|Japan Society for the Promotion Science [25893059]

Available from: 2016-01-11 Created: 2016-01-11 Last updated: 2016-06-05

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Perkiö Kato, NaokoJohansson, PeterStrömberg, AnnaJaarsma, Tiny
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Faculty of Medicine and Health SciencesDivision of Health, Activity and CareDepartment of Cardiology in LinköpingDivision of Cardiovascular MedicineDivision of Nursing Science
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