The European Society of Cardiology
Heart failure case disease management program: a pilot study of home telemonitoring versus usual care
Fondazione "Salvatore Maugeri", IRCCS, PAVIA, Dipartimento di Cardiologia, Istituto Scientifico di Montescano, Italy
* Correspondence: Soccorso Capomolla, MD, Department of Cardiology, Istituto Scientifico di Montescano, Via pe Montescano, 27040 Montescano, Pavia, Italy. Tel.: +39 0385 2471; fax: +39 0385 61386 (E-mail: scapomolla{at}fsm.it).
Abstract
BACKGROUND: Telemonitoring care can be integrated into health care provision as a substitute for routine clinical follow-up. A telemonitoring service (TMS) integrated into the process of chronic heart failure (CHF) care has not so far been evaluated.
OBJECTIVES: We describe our comprehensive home TMS and evaluate its outcomes in comparison to the usual program of care after discharge from a Heart Failure Unit (HFU).
METHODS: 133 patients discharged from a HFU, underwent risk cluster classification for cardiac events and were prospectively randomized to usual community care (n=66) and to a management program delivered by the TMS (n=67). Clinical outcome including re-hospitalization, cardiac death, and emergency room access, was compared in the two groups.
RESULTS: Patients were clustered as at low (n=51), moderate (n=43) and high (n=39) risk. The compliance to telemonitoring was 82%. The compliance to system follow-up was (81%). The mean individual access rate to the TMS was 4.6±3.3 calls. Active interventions were made following 54% of the accesses. After 10±6 months, 135 events had occurred: 103 in the usual care group and 32 in telemonitoring group (P<0.001). Re-hospitalisation was 22 (TMS) vs 77 (usual care) (P<0.009). Cluster risk classification intercepted patients' increased health care demands (low risk: 0.34±0.62; moderate risk 1±1.2; high risk 1.9±1.5 events)
CONCLUSION: A management program delivered by a TMS can reduce health care demands by CHF patients.
Keywords Chronic heart failure; Telemonitoring; Usual care
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