Einfluss einer telemedizinisch unterstützten Betreuung auf Gesamtbehandlungskosten und Mortalität bei chronischer Herzinsuffizienz

Kielblock, Birgit; Frye, Ch; Kottmair, Stefan; Hudler, Th; Siegmund-Schultze, Elisabeth; Middeke, Martin

doi:10.1055/s-2007-970350

Cited by 48 publications

(28 citation statements)

References 24 publications

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“…An overall reduction in cost of 39.5% was achieved. The evaluation was conducted in a stratified manner over a 1-year period, while the observation period was in fact at least 6 months and at most 18 [30]. …”

Section: Presentation Of Individual Projectsmentioning

confidence: 99%

Telemedical Support in Patients with Chronic Heart Failure: Experience from Different Projects in Germany

Müller

Schweizer

Helms

et al. 2010

International Journal of Telemedicine and Applications

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The great epidemiological significance and costs associated with chronic heart failure pose a challenge to health systems in Western industrial countries. In the past few years, controlled randomised studies have shown that patients with chronic heart failure benefit from telemedical monitoring; specifically, telemonitoring of various vital parameters combined with a review of the symptoms, drug compliance and patient education. In Germany, various telemedical monitoring projects for patients with chronic heart failure have been initiated in the past few years; seven of them are presented here. Currently 7220 patients are being monitored in the seven selected projects. Most patients (51.1%) are in NYHA stage II, 26.3% in NYHA stage III, 14.5% in NYHA stage I and only 6.6% in NYHA stage IV respectively. Most projects are primarily regional. Their structure of telemedical monitoring tends to be modular and uses stratification according to the NYHA stages. All projects include medical or health economics assessments. The future of telemedical monitoring projects for patients with chronic heart failure will depend on the outcome of these assessments. Only of there is statistical evidence for medical benefit to the individual patient as well as cost savings will these projects continue.

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Section: Presentation Of Individual Projectsmentioning

confidence: 99%

Telemedical Support in Patients with Chronic Heart Failure: Experience from Different Projects in Germany

Müller

Schweizer

Helms

et al. 2010

International Journal of Telemedicine and Applications

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“…Diese ist heute vor Beginn einer antihypertensiven Medikation unabdingbar. Für die Therapiesteuerung im Alltag über einen längeren Zeitraum ist die Blutdruck-Selbstmessung sehr gut geeignet (1,6,8,12,14,15,21,23,27) (2,9,10,19,25). Das Sicherheitserleben und die Lebensqualität der telemedizinisch betreuten Patienten können positiv beeinflusst werden, müssen aber noch spezifischer in zukünftigen Studien erfasst werden (24).…”

Section: Martin Middekeunclassified

Telemetrische Blutdruck– und Therapiekontrolle – Ein Instrument zur Förderung der Therapieadhärenz

Middeke¹

2009

Klinikarzt

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Die verschiedenen Blutdruck-Messverfahren ergänzen sich in sinnvoller Weise. Sie haben einen unterschiedlichen Stellenwert und jeweils bestimmte Vorund Nachteile. Während für die sichere Diagnosestellung einer manifesten Hypertonie die ambulante Blutdruck-Langzeitmessung überragende Bedeutung hat, erscheint die telemetrische Blutdruckmessung für die Therapiesteuerung sehr gut geeignet. Das telemetrische Monitoring (telemetrische Datenübertragung) der selbst gemessenen Blutdruckwerte und die damit verbundene (telefonisch) Therapiesteuerung ist ein viel versprechendes Verfahren, um die dauerhafte Blutdruckeinstellung und Therapieadhärenz zu verbessern. Hiervon können insbesondere Risikopatienten, z. B. mit schwer einstellbarer Hypertonie, hypertensiver Krise, chronischer Herzinsuffizienz und weiteren Indikationen profitieren.

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“…A number of studies have shown that telemonitoring improves the quality of life of patients and their families [9,10]. From an economic view point, home telemonitoring of chronic patients appears to reduce health care costs [11-14]. Nevertheless, higher-quality economic studies are required to give greater insights into the potential cost-effectiveness of home telemonitoring [15].…”

Section: Introductionmentioning

confidence: 99%

Assessment of a primary care-based telemonitoring intervention for home care patients with heart failure and chronic lung disease. The TELBIL study

Martín-Lesende

Orruño

Cairo

et al. 2011

BMC Health Serv Res

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BackgroundTelemonitoring technology offers one of the most promising alternatives for the provision of health care services at the patient's home. The primary aim of this study is to evaluate the impact of a primary care-based telemonitoring intervention on the frequency of hospital admissions.Methods/designA primary care-based randomised controlled trial will be carried out to assess the impact of a telemonitoring intervention aimed at home care patients with heart failure (HF) and/or chronic lung disease (CLD). The results will be compared with those obtained with standard health care practice. The duration of the study will be of one year. Sixty patients will be recruited for the study. In-home patients, diagnosed with HF and/or CLD, aged 14 or above and with two or more hospital admissions in the previous year will be eligible.For the intervention group, telemonitoring will consist of daily patient self-measurements of respiratory-rate, heart-rate, blood pressure, oxygen saturation, weight and body temperature. Additionally, the patients will complete a qualitative symptom questionnaire daily using the telemonitoring system. Routine telephone contacts will be conducted every fortnight and additional telephone contacts will be carried out if the data received at the primary care centre are out of the established limits. The control group will receive usual care. The primary outcome measure is the number of hospital admissions due to any cause that occurred in a period of 12 months post-randomisation. The secondary outcome measures are: duration of hospital stay, hospital admissions due to HF or CLD, mortality rate, use of health care resources, quality of life, cost-effectiveness, compliance and patient and health care professional satisfaction with the new technology.DiscussionThe results of this study will shed some light on the effects of telemonitoring for the follow-up and management of chronic patients from a primary care setting. The study may contribute to enhance the understanding of alternative modes of health care provision for medically unstable elderly patients, who bear a high degree of physical and functional deterioration.Trial RegistrationISRCTN: ISRCTN89041993

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Einfluss einer telemedizinisch unterstützten Betreuung auf Gesamtbehandlungskosten und Mortalität bei chronischer Herzinsuffizienz

Abstract: The results indicate that total treatment costs and mortality rate can be reduced by telemetric monitoring of patients in CHF, especially in men.

Cited by 48 publications

References 24 publications

Telemedical Support in Patients with Chronic Heart Failure: Experience from Different Projects in Germany

Telemedical Support in Patients with Chronic Heart Failure: Experience from Different Projects in Germany

Telemetrische Blutdruck– und Therapiekontrolle – Ein Instrument zur Förderung der Therapieadhärenz

Assessment of a primary care-based telemonitoring intervention for home care patients with heart failure and chronic lung disease. The TELBIL study

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