Protocol for Telehealth Evaluation and Follow-up of Patients With Chronic Heart Failure During the COVID-19 Pandemic.
Francesco Orso, Marta Migliorini, Andrea Herbst and 13 others
PMID 33256959WHAT IT FOUND
A 23-item telephone questionnaire and a 0 to 29 score assigned 30 older heart failure patients to green, yellow, or red follow-up intervals.
During the first month, 2 died and 5 were hospitalized. This is early implementation, not evidence it works.
Key findings
01The follow-up used a 23-item questionnaire and a 0 to 29 score to assign green, yellow, or red groups and plan next telephone contact after 4, 2, or 1 week.
02In the first 30 patients followed for 4 weeks, 60% were green, 17% red, 2 died, and 5 were admitted to hospital.
03The authors say the score is not yet a prognostic score and is only a potentially useful emergency tool for scheduling reevaluation and identifying patients who may need urgent hospital evaluation.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 30 patients were described, with no control group, so the report cannot show that the telephone score improved outcomes. The score cutoffs were arbitrary and based on clinical judgment and literature review, not validation. The authors state the score is not yet a prognostic score and needs longitudinal validation. Telephone assessment may overestimate or underestimate clinical condition, and some answers may reflect caregiver perception. The score focuses on heart failure and does not account for frailty or non-cardiovascular comorbidities. The authors state the score did not identify and prevent non-heart-failure complications such as cerebrovascular events, sepsis, or COVID-19 pneumonia. The report gives inconsistent death counts: 2 deaths during the first month, but 3 patients had died at 4 weeks.
The easy way to misread this
Do not conclude that the telephone score improves heart failure outcomes. It was used in only 30 patients without a control group, and the authors state it is not a validated prognostic score.