Long-term impact of a six-month telemedical care programme on mortality, heart failure readmissions and healthcare costs in patients with chronic heart failure. (June 2019)

• Record Type: Journal Article
• Authors: Frederix, Ines; Vanderlinden, Lien; Verboven, Anne-Sophie; Welten, Maria; Wouters, Donna; De Keulenaer, Gilles; Ector, Bavo; Elegeert, Ivan; Troisfontaines, Pierre; Weytjens, Caroline; Mullens, Wilfried; Dendale, Paul
• Is Part Of: Journal of telemedicine and telecare. Volume 25:Number 5(2019)
• Page Start: 286
• Page End: 293
• Publication Date: 2019-06
• Subjects: Telecardiology -- Telemedicine -- Cost-effectiveness; Telecommunication in medicine -- Periodicals; 610
• DOI: 10.1177/1357633X18774632
• Languages: English
• ISSNs: 1357-633X

Abstract

Aims: The TElemonitoring in the MAnagement of Heart Failure (TEMA-HF) 1 long-term follow-up study assessed whether an initial six-month telemonitoring (TM) programme compared with usual care (UC) would result in reduced all-cause mortality, heart failure admissions and healthcare costs in chronic heart failure (CHF) patients at long-term follow-up. Methods: Of the 160 patients included in the multi-centre, randomised controlled telemonitoring trial (TEMA-HF 1, time point t 0 ); 142 CHF patients (65% male; age: 76 ± 10 years; EF: 36 ± 15%) were alive and entered the follow-up study (time point: t 1 ) with a final evaluation at 79 months (time point: t 2 ). Both TM and UC group patients received standard heart failure care during the follow-up study (time points: t 1 – t 2 ). The primary endpoint was all-cause mortality. Secondary outcomes included days lost due to heart failure readmissions and readmission/patient follow-up related healthcare costs. Results: Compared with usual care, the initial six-month TM programme had no significant effect on all-cause mortality (hazard ratio: 0.83; 95% confidence interval, 0.57 to 1.20; p = 0.32). The number of days lost due to heart failure readmissions was significantly lower in the TM group ( p = 0.04). Healthcare costs did not differ significantly between the TM (€ 9140 ± 10580) and UC group (€ 12495 ± 22433) ( p = 0.87). Discussion: An initial six-month telemonitoring programme was not associated with reduced all-cause mortality in CHF patients at long-term follow-up but resulted in a reduction in the number of days lost due to heart failure readmissions. This study is registered in the ClinicalTrials.gov registry (NCT03171038) (URL:https://clinicaltrials.gov/ct2/show/NCT03171038 ).