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Noninvasive remote telemonitoring for ambulatory patients with heart failure: effect on number of hospitalizations, days in hospital, and quality of life. CARME (CAtalan Remote Management Evaluation)

Rev Esp Cardiol. 2011 Apr;64(4):277-85. Domingo M, Lupón J, González B, Crespo E, López R, Ramos A, Urrutia A, Pera G, Verdú JM, Bayes-Genis A. Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.

INTRODUCTION AND OBJECTIVES: Multidisciplinary strategies for the management of heart failure (HF) improve outcomes. We aimed to evaluate the effectiveness of noninvasive home telemonitoring in ambulatory patients with HF already included in a structured multidisciplinary HF program.

METHODS: Prospective intervention study with before/after comparison design of an interactive telemedicine platform in HF patients, randomized 1:1 into two groups: A) Motiva System with educational videos, motivational messages, and questionnaires, and B) Motiva System + self monitoring of blood pressure, heart rate, and weight. Hospitalizations were compared over 12 months prior to and post study inclusion. Quality of life was evaluated using the generic EuroQoL visual analogue scale and the specific questionnaire Minnesota Living With Heart Failure Questionnaire.

RESULTS: There were 92 patients included (71% male; 66.3 ± 11.5 years; 71% ischemic aetiology). During real-time telemonitoring over 11.8 months (interquartile range 8.6-12), 14,730 questionnaires were administered with 89% median response rate. Hospitalizations for HF decreased by 67.8% (P = .010) and for other cardiac causes by 57.6% (P = .028). The number of days in hospital for HF decreased by 73.3% (P =.036), without statistically significant differences between groups, and for other cardiac causes by 82.9% (P =.008). The perception of quality of life improved significantly both for the generic scale (P < .001) and for the HF specific questionnaire (P=.005).

CONCLUSIONS: HF patients who used an interactive telehealth system with motivational support tools at home spent less time in hospital and felt their quality of life had significantly improved. No significant differences were observed between groups.

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