• Nancy L Dawson, Bryan P Hull, Priyanka Vijapura, Adrian G Dumitrascu, Colleen T Ball, Kay M Thiemann, Michael J Maniaci, and M Caroline Burton.
• Division of Hospital Internal Medicine, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA. dawson.nancy11@mayo.edu.
• J Gen Intern Med. 2021 Nov 1; 36 (11): 3395-3401.

BackgroundHome telemonitoring has been used with discharged patients in an attempt to reduce 30-day readmissions with mixed results.ObjectiveTo assess whether home 30-day telemonitoring after discharge for patients at high risk of readmission would reduce readmissions or mortality.DesignProspective, randomized controlled trial.PatientsWe compared 30-day readmission rates and mortality for patients at high risk for readmission who received home telemonitoring versus standard care between November 1, 2014, and November 30, 2018, in 2 tertiary care hospitals.InterventionsThe intervention group received home-installed equipment to measure blood pressure, heart rate, pulse oximetry, weight if heart failure was present, and glucose if diabetes was present. Results were transmitted daily and reviewed by a nurse. Both groups received standard care.Main MeasuresThe primary outcome was a composite end point of hospital readmission or death within 30 days after discharge. The secondary outcome was an emergency department visit within 30 days after discharge.Key ResultsA total of 1380 participants (mean [SD] age, 66 [14] years; 722 [52.3%] men and 658 [47.7%] women) participated in this study. Using a modified intention-to-treat analysis, the risk of readmission or death within 30 days among patients at high readmission risk was 23.7% (137/578) in the control group and 18.2% (87/477) in the telemonitoring group (absolute risk difference, - 5.5% [95% CI, - 10.4 to - 0.6%]; relative risk, 0.77 [95% CI, 0.61 to 0.98]; P = .03). Emergency department visits occurred within 30 days after discharge in 14.2% (81/570) of patients in the control group and 8.6% (40/464) of patients in the telemonitoring group (absolute risk difference, - 5.6% [95% CI, - 9.4 to - 1.8%]; relative risk, 0.61 [95% CI, 0.42 to 0.87]; P = .005).ConclusionsThirty days of postdischarge telemonitoring may reduce readmissions of high-risk patients.Trial RegistrationClinicalTrials.gov identifier: NCT02136186.© 2021. Society of General Internal Medicine.

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