Effectiveness of a Telehealth Intervention on Functional Status, Anxiety, Depression, and Rehospitalization Among Older Adults Undergoing Coronary Artery Bypass Grafting: Randomized Controlled Trial
Bibliographic record
Abstract
<sec> <title>BACKGROUND</title> Telehealth has shown promise in enhancing care transitions and physical health outcomes in patients with cardiovascular disease. However, limited studies have explored its effect on functional status, psychological health, and rehospitalization, specifically in older patients undergoing coronary artery bypass grafting (CABG). </sec> <sec> <title>OBJECTIVE</title> This study aimed to evaluate the effectiveness of a telehealth intervention in improving functional status, reducing anxiety and depression, and decreasing rehospitalization rates compared with usual care among older patients undergoing CABG. </sec> <sec> <title>METHODS</title> The study was a two-arm parallel randomized controlled trial. This was conducted in two phases. Phase 1 was conducted in the cardiac surgical units at a university hospital in Bangkok, Thailand. Phase 2 involved following up with the participant at home 30 and 90 days after discharge. A total of 84 older adults undergoing CABG were randomly assigned to either the control group (n = 42), which received usual care (discharge planning), or the intervention group (n = 42), which received a telehealth intervention based on the Transitional Care Model in addition to usual care. The telehealth intervention included home monitoring via the “Zip Heart” application and scheduled video consultations. The primary outcome was functional status, measured using the Thai version of the Enforced Social Dependency Scale (Thai ESDS). Secondary outcomes included anxiety and depression, assessed using the Thai Hospital Anxiety and Depression Scale (Thai HADS), and rates of rehospitalization. Data were collected at baseline, 30 and 90 days after discharge. Data analyses were performed using two-way repeated-measures analysis of variance. </sec> <sec> <title>RESULTS</title> A total of 41 participants in each group completed the study. Significant improvements in functional status and reductions in anxiety and depression at 30 and 90 days after discharge were observed in the intervention group compared to the control group. Additionally, the intervention group demonstrated lower rehospitalization rates at both time points. </sec> <sec> <title>CONCLUSIONS</title> The Telehealth intervention is effective in improving functional and psychological outcomes and reducing rehospitalization rates among older patients undergoing CABG. Integrating telehealth into usual care can support recovery and enhance continuity of care. </sec> <sec> <title>CLINICALTRIAL</title> ClinicalTrials.govTCTR20230816008;http://clinicaltrials.gov/ct2/show/TCTR20230816008 </sec>
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".