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

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.

Effective Technologies for Noninvasive Remote Monitoring in Heart Failure

“…The effectiveness of interactive voice response devices was examined in two studies included in our review. 16,24 No significant reductions in the RR of all-cause mortality, all-cause hospitalizations, or heart failure-related hospitalizations were observed in either of these studies ( Table 2).…”

“…16,24 The trials enrolled 594 patients in total, and there were no significant reductions in mortality or hospitalizations identified in either of the studies. These findings are consistent with a more recent and larger randomized controlled trial of interactive voice response technology, which was published after our systematic review.…”

Adherence to a physical activity intervention among older adults in a post-transitional middle income country: A quantitative and qualitative analysis

“…The evidence also shows that positive reinforcement, social interaction, and leadership characteristics are positively correlated with adherence [33][34][35]. These results suggest the importance of adapting PA interventions to include enjoyable activities and promote social interaction to enhance participation.…”

Desarrollo de un sistema de telemetría para el seguimiento postoperatorio de procedimientos en cirugía vascular: modelo in vitro

“…Por lo tanto, aunque el diseño, desarrollo e implementación de los sistemas WSN/WBAN representa una tarea difícil con varias cuestiones de una elevada dificultad técnica, los beneficios de su utilización para la prevención, diagnóstico precoz y gestión de las enfermedades son múltiples y ampliamente documentados (141,(154)(155)(156)(157)(158)(159)(160) .…”