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J Telemed Telecare. 2019 Apr;25(3):158-166. doi: 10.1177/1357633X17747641. Epub 2017 Dec 17.

Telemonitoring in patients with heart failure: Is there a long-term effect?

Author information

1
1 Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
2
2 Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands.
3
3 Department of Cardiology, Zuyderland Hospital, Sittard, The Netherlands.
4
4 Department of Cardiology, Zuyderland Hospital, Heerlen, The Netherlands.
5
5 Department of Cardiology, RWTH University Hospital, Aachen, Germany.
6
6 Department of Family Medicine, Vrije Universiteit Brussels, Brussels, Belgium.
7
7 Panaxea BV, Amsterdam, The Netherlands.
8
8 Department of Patient and Care, Maastricht University Medical Centre, Maastricht, The Netherlands.
9
9 CAPHRI, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.

Abstract

INTRODUCTION:

Evidence suggests that telemonitoring decreases mortality and heart failure (HF)-related hospital admission in patients with HF. However, most studies follow their patients for only several months. Little is known about the long-term effects of telemonitoring after a period of application.

METHODS:

In 2007, the TEHAF study was initiated to compare tailored telemonitoring with usual care with respect to time until first HF-related hospital admission. In total, 301 patients completed the study after a follow-up period of one year. No differences could be found in time to first HF-related admission between intervention and control groups. Here, we performed a retrospective analysis in order to investigate potential long-term effects of telemonitoring. The primary endpoint was time to first HF-related hospital admission. Secondary endpoints were, amongst others, all-cause mortality, hospital admission due to HF and days alive and out of hospital (DAOOH). Electronic files of all included patients were reviewed between October 2007 and September 2015.

RESULT:

Mean follow-up duration was 1652 days (standard deviation: 1055 days). No significant difference in time to first HF-related hospital admission (log-rank test, p = 0.15), all-cause mortality (log-rank test, p = 0.43), or DAOOH (two-sample t-test, p = 0.87) could be found. However, patients that underwent telemonitoring had significantly fewer HF-related hospital admissions (incident rate ratio 0.54, 95% confidence interval 0.31-0.88).

DISCUSSION:

Telemonitoring did not significantly influence the long-term outcome in our study. Therefore, extending the follow-up period of telemonitoring studies in HF patients is probably not beneficial.

KEYWORDS:

Heart failure; hospital admission; long-term effects; mortality; telemonitoring

PMID:
29251245
DOI:
10.1177/1357633X17747641
[Indexed for MEDLINE]

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