Combined telemonitoring and telecoaching for heart failure improves outcome.


Journal

NPJ digital medicine
ISSN: 2398-6352
Titre abrégé: NPJ Digit Med
Pays: England
ID NLM: 101731738

Informations de publication

Date de publication:
17 Oct 2023
Historique:
received: 19 03 2023
accepted: 05 10 2023
medline: 18 10 2023
pubmed: 18 10 2023
entrez: 17 10 2023
Statut: epublish

Résumé

Telemedicine has been shown to improve the outcome of heart failure (HF) patients in addition to medical and device therapy. We investigate the effectiveness of a comprehensive telehealth programme in patients with recent hospitalisation for HF on subsequent HF hospitalisations and mortality compared to usual care in a real-world setting. The telehealth programme consists of daily remote telemonitoring of HF signs/symptoms and regular individualised telecoaching sessions. Between January 2018 and September 2020, 119,715 patients of a German health insurer were hospitalised for HF and were eligible for participation in the programme. Finally, 6065 HF patients at high risk for re-hospitalisation were enroled. Participants were retrospectively compared to a propensity score matched usual care group (n = 6065). Median follow-up was 442 days (IQR 309-681). Data from the health insurer was used to evaluate outcomes. After one year, the number of hospitalisations for HF (17.9 vs. 21.8 per 100 patient years, p < 0.001), all-cause hospitalisations (129.0 vs. 133.2 per 100 patient years, p = 0.015), and the respective days spent in hospital (2.0 vs. 2.6 days per year, p < 0.001, and 12.0 vs. 13.4, p < 0.001, respectively) were significantly lower in the telehealth than in the usual care group. Moreover, participation in the telehealth programme was related to a significant reduction in all-cause mortality compared to usual care (5.8 vs. 11.0 %, p < 0.001). In a real-life setting of ambulatory HF patients at high risk for re-hospitalisation, participation in a comprehensive telehealth programme was related to a reduction of HF hospitalisations and all-cause mortality compared to usual care.

Identifiants

pubmed: 37848681
doi: 10.1038/s41746-023-00942-4
pii: 10.1038/s41746-023-00942-4
pmc: PMC10582035
doi:

Types de publication

Journal Article

Langues

eng

Pagination

193

Subventions

Organisme : Deutsche Stiftung für Herzforschung (German Heart Research Foundation)
ID : F/26/20

Informations de copyright

© 2023. Springer Nature Limited.

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Auteurs

Katharina Knoll (K)

German Heart Centre Munich, Department of Cardiology, Technical University Munich, Munich, Germany.
DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.

Stefanie Rosner (S)

German Heart Centre Munich, Department of Cardiology, Technical University Munich, Munich, Germany.

Stefan Gross (S)

Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.
DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany.

Dino Dittrich (D)

Health Care Systems GmbH (HCSG), Pullach im Isartal, Germany.

Carsten Lennerz (C)

German Heart Centre Munich, Department of Cardiology, Technical University Munich, Munich, Germany.
DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.

Teresa Trenkwalder (T)

German Heart Centre Munich, Department of Cardiology, Technical University Munich, Munich, Germany.
DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.

Stefanie Schmitz (S)

Krankenkasse KNAPPSCHAFT, Bochum, Germany.

Stefan Sauer (S)

Novartis Pharma GmbH, Nürnberg, Germany.

Christian Hentschke (C)

Novartis Pharma GmbH, Nürnberg, Germany.

Marcus Dörr (M)

Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.
DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany.

Christian Kloss (C)

Health Care Systems GmbH (HCSG), Pullach im Isartal, Germany.

Heribert Schunkert (H)

German Heart Centre Munich, Department of Cardiology, Technical University Munich, Munich, Germany.
DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.

Wibke Reinhard (W)

German Heart Centre Munich, Department of Cardiology, Technical University Munich, Munich, Germany. w.hengstenberg@tum.de.

Classifications MeSH