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The European Society of Cardiology

Heart failure case disease management program: a pilot study of home telemonitoring versus usual care

Soccorso Capomolla*, GianDomenico Pinna, Maria Teresa La Rovere, Roberto Maestri, Monica Ceresa, Marina Ferrari, Oreste Febo, Angelo Caporotondi, Giampaolo Guazzotti, Francesca Lenta, Sonia Baldin, Andrea Mortara1 and Franco Cobelli

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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