The Patient Experience of Remote Telemonitoring for Heart Failure in the Rural Setting: A Literature Review.

BACKGROUND: Remote telemonitoring has been identified as an effective method to provide specialist care to people with heart failure living in rural and remote locations. However, to date there has been limited research into patients' experience and acceptance of a telemonitoring service, particularly in a rural setting. OBJECTIVE: This review of the literature was conducted for the purpose of examining the evidence that is available to inform the development of a telemonitoring service for patients with heart failure living in rural and remote Queensland. METHODS: Cochrane Database of Systematic Reviews; Medline; CINAHL database, Joanna Briggs Institute, AMED, EMBASE were searched using the following key words: Heart Failure, Telemonitoring, Community Health, Rural, Acceptance, Adherence, Remote Monitoring, Patient Experience. A thematic analysis was applied to the data. RESULTS: The initial search identified 46 published studies of which 11 met the designated inclusion criteria. The literature analysed identified factors that influenced the patients' experience and acceptance of a telemonitoring service. The most prominent influences on the patient experience, acceptance and adherence to telemonitoring, included the operation of telemonitoring equipment, the stability/severity of the telemonitoring recipient's chronic disease (i.e. Heart Failure), and the effect of the use of telemonitoring on the patient's identity, autonomy and daily living. CONCLUSION: There is a paucity of literature available addressing the patient experience and factors affecting acceptance and adherence to telemonitoring services generally. In addition, there appears to be a complete absence of studies that specifically investigate the experiences of patients living with heart failure in rural and remote locations. Further research is needed to: examine the patient/user perspective of this type of medical service, explore the effects of tailored educational resources and technological supports offered to patients, and explore the feasibility of including telemonitoring in usual care.