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Evaluation of a telemedicine system for heart failure patients: Feasibility, acceptance rate, satisfaction and changes in patient behavior Results from the CARME (CAtalan Remote Management Evaluation)

Eur J Cardiovasc Nurs. 2011 Mar 12 Domingo M, Lupón J, González B, Crespo E, López R, Ramos A, Urrutia A, Pera G, Verdú JM, Bayes-Genis A. Unitat d'Insuficiència Cardíaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Equipo de Atención Primaria Sant Roc, Institut Català de la Salut, Badalona, Barcelona, Spain; Unitat de Suport a la Recerca Metropolitana Nord, Institut d'Investigació en Atenció Primària Jordi Gol, Institut Català de la Salut, Spain.

BACKGROUND: Telemedicine can be useful for managing heart failure (HF), but patient acceptance of telemedicine and its impact on patient behavior are unclear.

AIMS: To assess a telemedicine program in a HF Unit.

METHODS AND RESULTS: This sub-analysis of the CARME study assessed the use of an interactive telemedicine platform. This prospective intervention study had a before/after design with HF patients randomized 1:1 into two groups: A) Motiva system (educational videos, motivational messages, and questionnaires); and B) Motiva system+telemonitoring of blood pressure, heart rate and weight. Of 211 patients screened, 44 were excluded, 62 did not consent to participate and 8 withdrew consent prior to installation of the system. The final study population included 97 patients. During 1year of follow-up, 22 patients voluntarily discontinued use of the system, 5 died (three after early discontinuation) and 5 withdrew consent before the last evaluation. A total of 15,017 questionnaires were sent to patients, with a median response rate of 88%. Satisfaction with the system and tools was high (median score 8.4/10), especially with the self-monitoring chart, scale and sphygmomanometer. Positive changes were observed in patient behavior, especially for blood pressure and weight control (p<0.001). After the study, 65% of the patients wished to continue with telemonitoring, particularly those in Group B (p=0.004).

CONCLUSION: Less than half of our patients participated in the telemedicine study. However, those who completed the study had confidence in the system, a high degree of satisfaction with the tools and positive behavioral changes.

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