Clinical and psychological telemonitoring and telecare of high risk heart failure patients.

Published on Oct 22, 2014in Journal of Telemedicine and Telecare2.616
· DOI :10.1177/1357633X14555644
Alessandra Villani15
Estimated H-index: 15
,
Gabriella Malfatto26
Estimated H-index: 26
+ 5 AuthorsGianfranco Parati122
Estimated H-index: 122
Sources
Abstract
We conducted a trial of telemonitoring and telecare for patients with chronic heart failure leaving hospital after being treated for clinical instability. Eighty patients were randomized before hospital discharge to a usual care group (n = 40: follow-up at the outpatient clinic) or to an integrated management group (n = 40: patients learned to use a handheld PDA and kept in touch daily with the monitoring centre). At enrolment, the groups were similar for all clinical variables. At one-year follow-up, integrated management patients showed better adherence, reduced anxiety and depression, and lower NYHA class and plasma levels of BNP with respect to the usual care patients (e.g. NYHA class 2.1 vs 2.4, P < 0.02). Mortality and hospital re-admissions for congestive heart failure were also reduced in integrated management patients (P < 0.05). Integrated management was more expensive than usual care, although the cost of adverse events was 42% lower. In heart failure patients at high risk of relapse, the regul...
📖 Papers frequently viewed together
278 Citations
52 Citations
201123.60Circulation
467 Citations
References28
Newest
Abstract Background: Studies focusing on the effects of telemanagement programs for chronic heart failure (CHF) on functional status are lacking, and the prognostic value of the clinical response to the programs is unknown. In the Lombardy region of Italy, a home-based telesurveillance program (HTP) including multidisciplinary management and remote telemonitoring for patients with CHF was introduced in 2000 and was formally adopted, as part of the services delivered by the regional healthcare sy...
17 CitationsSource
#1S. Adamopoulos (Glas.: University of Glasgow)H-Index: 15
#2Stefan D. AnkerH-Index: 173
Last. Andreas M. ZeiherH-Index: 147
view all 13 authors...
The originally published version of this paper was incorrect. In the table on page 1816, the Class of recommendation and Level of evidence for ‘The patient is pacemaker dependent as a result of AV nodal ablation’ should have read ‘IIa’ and ‘B’ respectively. Appendix: six tables ([3][1
5,437 CitationsSource
#1Catherine R. Norton (Emory University)H-Index: 3
#2Vasiliki V. Georgiopoulou (Emory University)H-Index: 32
Last. Javed Butler (Emory University)H-Index: 99
view all 4 authors...
Abstract The public health impact and the need to intervene upon the worsening heart failure (HF) epidemic are currently a matter of national interest. The greater than $39 billion annual cost of caring for the 5.8 million patients living with HF in the United States places a considerable burden on the health care system. In 2006, HF was a contributing factor in more than 250,000 deaths. HF is the primary cause of more than 1 million and a contributing cause for more than 3 million hospitalizati...
86 CitationsSource
#1Sarwat I. Chaudhry (Yale University)H-Index: 28
#2Jennifer A. MatteraH-Index: 35
Last. Harlan M. Krumholz (Yale University)H-Index: 215
view all 10 authors...
Methods We randomly assigned 1653 patients who had recently been hospitalized for heart failure to undergo either telemonitoring (826 patients) or usual care (827 patients). Telemonitoring was accomplished by means of a telephone-based interactive voiceresponse system that collected daily information about symptoms and weight that was reviewed by the patients’ clinicians. The primary end point was readmission for any reason or death from any cause within 180 days after enrollment. Secondary end ...
887 CitationsSource
#1Sally C. Inglis (Baker IDI Heart and Diabetes Institute)H-Index: 21
#2Robyn Clark (QUT: Queensland University of Technology)H-Index: 30
Last. John G.F. Cleland (Castle Hill Hospital)H-Index: 154
view all 8 authors...
Background: Specialised disease management programmes for chronic heart failure (CHF) improve survival, quality of life and reduce healthcare utilisation. The overall efficacy of structured telephone support or telemonitoring as an individual component of a CHF disease management strategy remains inconclusive. Objectives: To review randomised controlled trials (RCTs) of structured telephone support or telemonitoring compared to standard practice for patients with CHF in order to quantify the eff...
485 CitationsSource
#1Caterina TridicoH-Index: 3
#2Giancarlo FontanaH-Index: 2
Last. SottocommissioneH-Index: 1
view all 13 authors...
2 CitationsSource
#1Shannon M. Dunlay (Mayo Clinic)H-Index: 52
#2Mihai Gheorghiade (NU: Northwestern University)H-Index: 141
Last. John A. SpertusH-Index: 141
view all 11 authors...
Aims Hospitalized heart failure (HF) patients are at high risk for death and readmission. We examined the incremental value of data obtained 1 week after HF hospital discharge in predicting mortality and readmission. Methods and results In the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study with tolvaptan, 1528 hospitalized patients (ejection fraction ≤40%) with a physical examination, laboratories, and health status [Kansas City Cardiomyopathy Questionnaire (KCCQ)] assessments...
58 CitationsSource
#1Paresh A Mehta (Imperial College London)H-Index: 4
#2Simon W DubreyH-Index: 30
Last. Martin R. CowieH-Index: 84
view all 8 authors...
Objective: To investigate the secular trend in survival after a new diagnosis of heart failure in the UK population. Design and Setting: Comparison of all-cause mortality in the 6 months after diagnosis of heart failure in population-based studies in the south east of England in 2004–5 (Hillingdon–Hastings Study) and 1995–7 (Hillingdon–Bromley Studies). Participants: 396 patients in the 2004–5 cohort and 552 patients in the 1995–7 cohort with incident (new) heart failure. Main Outcome Measures: ...
63 CitationsSource
#1Andrea MortaraH-Index: 39
#2Gian Domenico PinnaH-Index: 41
Last. Peter Sleight (John Radcliffe Hospital)H-Index: 108
view all 9 authors...
Aims The Home or Hospital in Heart failure (HHH) study was a European Community-funded, multinational, randomized controlled clinical trial, conducted in the UK, Poland, and Italy, to assess the feasibility of a new system of home telemonitoring (HT). The HT system was used to monitor clinical and physiological parameters, and its effectiveness (compared with usual care) in reducing cardiac events in heart failure (HF) patients was evaluated. Measurements were patient-managed. Methods and result...
119 CitationsSource
#1Kenneth DicksteinH-Index: 98
#2Alain Cohen-SolalH-Index: 60
Last. Faiez ZannadH-Index: 111
view all 47 authors...
3,093 CitationsSource
Cited By34
Newest
#1A. FaragliH-Index: 2
#2Dawud Abawi (Charité)H-Index: 2
Last. Alessio Alogna (Charité)H-Index: 6
view all 11 authors...
Heart failure (HF) patients represent one of the most prevalent as well as one of the most fragile population encountered in the cardiology and internal medicine departments nowadays. Estimated to account for around 26 million people worldwide, diagnosed patients present a poor prognosis and quality of life with a clinical history accompanied by repeated hospital admissions caused by an exacerbation of their chronic condition. The frequent hospitalizations and the extended hospital stays mean an...
2 CitationsSource
#2Maunika Reddy (BU: Boston University)
Last. Shivang Shah (LLU: Loma Linda University)
view all 6 authors...
Introduction null A wide range of study designs have been utilized in evaluations of home telemonitoring and these studies have produced conflicting outcomes over the years. While some of the research has shown that telemonitoring is beneficial in reducing all-cause mortality, hospital admission, length of stay in hospital and emergency room visits, other studies have not shown such benefits. This study, therefore, aims to examine several home telemonitoring study designs and the influence of st...
Source
#1Teemu E I Drews (HYKS: Helsinki University Central Hospital)
#2Jari A. Laukkanen (University of Eastern Finland)H-Index: 54
Last. Tuomo NieminenH-Index: 61
view all 3 authors...
We planned this systematic review and meta-analysis to study an estimate of the effect of non-invasive home telemonitoring (TM) in the treatment of patients with recently decompensated heart failure (HF). A systematic literature search was conducted in the Medline, Cinahl, and Scopus databases to look for randomized controlled studies comparing TM with standard care in the treatment of patients with recently decompensated HF. The main outcomes of interest were all-cause hospitalizations and mort...
Source
#1Ishaan Vohra (Loyola University Medical Center)
#2Bashar M. AttarH-Index: 21
Last. Seema GandhiH-Index: 6
view all 9 authors...
BACKGROUND AND STUDY AIM Ulcerative colitis (UC) is a chronic relapsing and remitting disease requiring frequent hospitalization. Biologics have become the recommended initial therapy for Biologics in patients with moderate to severe UC. Our aim was to estimate the changes in Nationwide Healthcare utilization and assess predictive factors of 30-day readmission, morbidity and mortality of UC. METHODS This is a retrospective observational study analyzing the Nationwide Readmission database from 20...
Source
#1Caroline Lang (TUD: Dresden University of Technology)H-Index: 5
#2Martin Roessler (TUD: Dresden University of Technology)H-Index: 2
Last. Vjera Holthoff-Detto (TUD: Dresden University of Technology)H-Index: 3
view all 5 authors...
PURPOSE Multimorbidity leads to decreasing health-related quality of life (HRQoL). Telemedicine may help to improve HRQoL. The present study was conducted to show (I) differences in HRQoL and changes in HRQoL over time in elderly, multimorbid individuals with and without depression and/or mild cognitive impairment (MCI) using a telemonitoring application (TMA) and (II) associations between engagement with measurements by study participants using a TMA and changes in their HRQoL. METHODS The pres...
Source
#1Ryan J. Bamforth (UM: University of Manitoba)
#2Ruchi Chhibba (UM: University of Manitoba)H-Index: 2
Last. Claudio Rigatto (UM: University of Manitoba)H-Index: 38
view all 9 authors...
BACKGROUND Readmission following hospital discharge is common and is a major financial burden on healthcare systems. OBJECTIVES Our objectives were to 1) identify studies describing post-discharge interventions and their efficacy with respect to reducing risk of mortality and rate of hospital readmission; and 2) identify intervention characteristics associated with efficacy. METHODS A systematic review of the literature was performed. We searched MEDLINE, PubMed, Cochrane, EMBASE and CINAHL. Our...
Source
#1Spyros Kitsiou (UIC: University of Illinois at Chicago)H-Index: 9
#2Haleh Vatani (UIC: University of Illinois at Chicago)H-Index: 2
Last. Ruth M. Masterson Creber (Cornell University)H-Index: 15
view all 8 authors...
Abstract Background Heart failure (HF) is a complex and serious condition associated with substantial morbidity, mortality, and healthcare costs. We conducted a systematic review and meta-analysis to evaluate the effects of mobile health technology (mHealth) interventions compared with usual care in patients with HF. Materials and Methods We searched MEDLINE, CENTRAL, CINAHL, and EMBASE databases to identify eligible randomized controlled trials (RCTs) of mHealth interventions. Primary outcomes ...
1 CitationsSource
#1Maria Nilsson (LNU: Linnaeus University)
#2Stefan Andersson (LNU: Linnaeus University)H-Index: 4
Last. Elizabeth Hanson (LNU: Linnaeus University)H-Index: 24
view all 4 authors...
Background and aims There is a growing demand for health and social care services to provide technology-mediated interventions that promote the health and well-being of older people with health or care needs and of their informal carers. The objectives of this study were to scope and review the nature and extent of prior intervention studies involving ambient assisted living technology-mediated interventions for older people and their informal carers, and how and in what ways (if any) the goals ...
Source
ObjectiveThis study examined Gold Coast staff and patient experiences with the rapid expansion of a virtual model of chronic disease management during the COVID-19 pandemic.MethodsThe study undertook a survey of enrolled patients (n=24) and focus groups with clinical and administrative staff (n=44) delivering chronic disease programs at Gold Coast Health in Queensland. The study also examined routinely collected activity data for the chronic disease programs before COVID (January-February 2020) ...
Source
#1Jesse F. VeenisH-Index: 6
#2Sumant P RadhoeH-Index: 2
Last. Jasper J. BrugtsH-Index: 22
view all 4 authors...
Heart failure (HF) is a major health care issue, and the incidence of HF is only expected to grow further. Due to the frequent hospitalizations, HF places a major burden on the available hospital and healthcare resources. In the future, HF care should not only be organized solely at the clinical ward and outpatient clinics, but remote monitoring strategies are urgently needed to guide, monitor, and treat chronic HF patients remotely from their homes as well. The intuitiveness and relatively low ...
Source