Telemedicine in heart failure—more than nice to have?

Eurlings, Casper; Boyne, Josiane; Boer, Rudolf A. de; Rocca, Hans‐Peter Brunner‐La

doi:10.1007/s12471-018-1202-5

Cited by 33 publications

(35 citation statements)

References 47 publications

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“…However, Eurlings et al [24] in their review underline that, even though new technology is evolving, the evidence is conflicting, mainly due to a lack of uniform methods to evaluate telehealth and standard care.…”

Section: Discussionmentioning

confidence: 99%

Remote monitoring in peritoneal dialysis: benefits on clinical outcomes and on quality of life

et al. 2020

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Background Automated peritoneal dialysis (APD) has been proved benefit from remote monitoring (RM), but evidences are limited. In this study, we compared clinical outcomes and quality of life (QoL) in two group of patients undergoing APD, with and without exposure of RM. Methods This is a retrospective cohort study, comparing outcomes in two groups of APD patients monitored during 6 months with RM (group A: n = 35) or standard care (group B: n = 38 patients). In our clinical practice, we assign the RM system to patients who live more distant from the PD center or difficulty in moving. We evaluated emergency visits, hospitalizations, peritonitis, overhydration, and dropout. QoL was assessed with the Kidney Disease Quality of life-Short Form (KDQOL-SF). We included four additional questions focused on patient's perception of monitoring, safety and timely problems solution (Do you think that home-therapy monitoring could interfere with your privacy? Do you think that your dialysis sessions are monitored frequently enough? Do you think that dialysis-related issues are solved timely? Do you feel comfortable carrying out your home-based therapy?). Results The case group presented a higher comorbidity score, according to Charlson Comorbidity Index (group A: 5.0; IQR 4.0-8.0 versus group B: 4.0; IQR 3.0-6.0) (p = 0.042). The results in group A showed a reduction in the urgent visits due to acute overhydration (group A: 0.17 ± 0.45 versus group B: 0.66 ± 1.36) (p: 0.042) and in the number of disease-specific hospitalization (group A n = 2.0; 18.2% versus group B n = 7.0; 77.8%) (p = 0.022). We did not find any difference between the two groups in terms of hospitalization because of all-cause, peritonitis, overhydration, and dropout. The analysis of KDQOL-SF subscales was similar in the two groups; on the contrary, the answers of our pointed questions have showed a significant difference between the two groups (group A: 100 IQR 87.5-100.0 versus group B 87.5; IQR 75.0-100.0) (p: 0.018). Conclusion RM improved clinical outcomes in PD patients, reducing the emergency visits and the hospitalizations, related to nephrological problems, especially in patients with higher comorbidity score. The acceptance and satisfaction of care were better in patients monitored with RM than with standard APD.

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Section: Discussionmentioning

confidence: 99%

Remote monitoring in peritoneal dialysis: benefits on clinical outcomes and on quality of life

et al. 2020

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“…When healthcare remains in the status quo future healthcare of patients with chronic diseases in general, and HF in particular, will be scarce [29]. Initiatives so far have not brought sufficient solutions [30]. Current organisation of HF care is not optimal and the capacity of health professionals is increasingly limited, resulting in a lack of focused effort on the most urgent cases.…”

Section: Necessity For a Paradigm Shift In The Care Of Hfmentioning

confidence: 99%

“…cough with sputum production in the setting of worsening breathlessness may indicate an infective process rather than deteriorating HF. However, telemonitoring can be more efficient than education alone in supporting patients and carers in detecting and interpreting symptoms [30]. In particular, the majority of patients with chronic diseases who are usually elderly may not be able to detect and interpret symptoms sufficiently without additional support.…”

Section: The Hf Paradigm Shift To Pppmmentioning

confidence: 99%

Artificial intelligence supported patient self-care in chronic heart failure: a paradigm shift from reactive to predictive, preventive and personalised care

et al. 2019

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Heart failure (HF) is one of the most complex chronic disorders with high prevalence, mainly due to the ageing population and better treatment of underlying diseases. Prevalence will continue to rise and is estimated to reach 3% of the population in Western countries by 2025. It is the most important cause of hospitalisation in subjects aged 65 years or more, resulting in high costs and major social impact. The current “one-size-fits-all” approach in the treatment of HF does not result in best outcome for all patients. These facts are an imminent threat to good quality management of patients with HF. An unorthodox approach from a new vision on care is required. We propose a novel predictive, preventive and personalised medicine approach where patients are truly leading their management, supported by an easily accessible online application that takes advantage of artificial intelligence. This strategy paper describes the needs in HF care, the needed paradigm shift and the elements that are required to achieve this shift. Through the inspiring collaboration of clinical and high-tech partners from North-West Europe combining state of the art HF care, artificial intelligence, serious gaming and patient coaching, a virtual doctor is being created. The results are expected to advance and personalise self-care, where standard care tasks are performed by the patients themselves, in principle without involvement of healthcare professionals, the latter being able to focus on complex conditions. This new vision on care will significantly reduce costs per patient while improving outcomes to enable long-term sustainability of top-level HF care.

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“…Telemedicine -or telehealth -applied to chronic diseases such as HF is rapidly evolving and aims to improve and individualise patient care, as well as reducing financial costs. 6 Telehealth is a broad term that encompasses the different applications of telematics to medicine, allowing diagnosis and/or remote treatment through a set of communication tools. 7 Additionally, a branch of computer science that could enhance future HF management is artificial intelligence (AI), an area of study engaging computers in human processes, such as learning, reasoning or knowledge storage.…”

Section: Digital Healthmentioning

confidence: 99%

“…This effect was maintained over a long-term period. 6 The continuous technical progress of implanted left ventricular assist The Contemporary Modalities In Treatment of Heart Failure (COMMIT-HF) registry evaluated the impact of RM on a long-term prognosis in HF patients. Findings from this investigation, which involved different cardiac device brands for the telemonitoring, strongly suggest that the use of RM improves long-term prognosis.…”

Section: Devices and Hardwarementioning

confidence: 99%

Telemedicine, Artificial Intelligence and Humanisation of Clinical Pathways in Heart Failure Management: Back to the Future and Beyond

et al. 2020

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New technologies have been recently introduced to improve the monitoring of patients with chronic syndromes such as heart failure. Devices can now be employed to gather large amounts of data and data processing through artificial intelligence techniques may improve heart failure management and reduce costs. The analysis of large datasets using an artificial intelligence technique is leading to a paradigm shift in the era of precision medicine. However, the assessment of clinical safety and the evaluation of the potential benefits is still a matter of debate. In this article, the authors aim to focus on the development of these new tools and to draw the attention to their transition in daily clinical practice.

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Telemedicine in heart failure—more than nice to have?

Cited by 33 publications

References 47 publications

Remote monitoring in peritoneal dialysis: benefits on clinical outcomes and on quality of life

Remote monitoring in peritoneal dialysis: benefits on clinical outcomes and on quality of life

Artificial intelligence supported patient self-care in chronic heart failure: a paradigm shift from reactive to predictive, preventive and personalised care

Telemedicine, Artificial Intelligence and Humanisation of Clinical Pathways in Heart Failure Management: Back to the Future and Beyond

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