Why patients stop using their home telehealth technologies over time: Predictors of discontinuation in Veterans with heart failure.

Abstract Background Daily use of home telehealth (HT) technologies decreases over time. Barriers to continued use are unclear. Purpose To examine predictors of drop-out from HT in Veterans with heart failure. Methods Data for Veterans with heart failure enrolled in the Veterans Affairs HT Program were analyzed using a mixed effects Cox regression model to determine risk of dropping-out over a 1-year period. Findings Older (hazard ratio [HR] 1.01), sicker (prior hospital readmission [HR 1.39]), higher probability of hospital admission/death [HR 1.23], functional impairments [1.14]) and white Veterans (compared to black; HR 1.41) had higher risk of drop-out in HT Programs. Users of VA's online patient portal (HR 0.90) had lower risk of drop-out. Discussion Older and sicker patients are at most risk of stopping HT use, yet use of a patient portal shows promise in improving continued use. Interventions targeting patients at high risk for HT discontinuation are needed to promote ongoing engagement.