Clinical and psychological telemonitoring and telecare of high risk heart failure patients
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...
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| Veröffentlicht in: | Journal of telemedicine and telecare 2014-12, Vol.20 (8), p.468-475 |
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| container_title | Journal of telemedicine and telecare |
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| creator | Villani, Alessandra Malfatto, Gabriella Compare, Angelo Rosa, Francesco Della Bellardita, Lara Branzi, Giovanna Molinari, Enrico Parati, Gianfranco |
| description | 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 |
| doi_str_mv | 10.1177/1357633X14555644 |
| format | Article |
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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 regular acquisition of simple clinical information and the possibility for the patient to contact the clinical staff improved drug titration, produced better psychological status and quality of life, and reduced hospitalizations for heart failure.</description><identifier>ISSN: 1357-633X</identifier><identifier>EISSN: 1758-1109</identifier><identifier>DOI: 10.1177/1357633X14555644</identifier><identifier>PMID: 25339632</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Aftercare - methods ; Aged ; Analysis of Variance ; Anxiety - etiology ; Delivery of Health Care, Integrated - methods ; Depressive Disorder - etiology ; Disease Management ; Female ; Health Care Costs ; Heart Failure - economics ; Heart Failure - psychology ; Heart Failure - therapy ; Home Care Services, Hospital-Based ; Humans ; Male ; Monitoring, Ambulatory - methods ; Patient Readmission - statistics & numerical data ; Quality of Life ; Telemedicine - economics</subject><ispartof>Journal of telemedicine and telecare, 2014-12, Vol.20 (8), p.468-475</ispartof><rights>The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav</rights><rights>The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-5276f12f564d710d3914418e6d8c999df2128b407055f62521696364731f0fca3</citedby><cites>FETCH-LOGICAL-c337t-5276f12f564d710d3914418e6d8c999df2128b407055f62521696364731f0fca3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1357633X14555644$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1357633X14555644$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25339632$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Villani, Alessandra</creatorcontrib><creatorcontrib>Malfatto, Gabriella</creatorcontrib><creatorcontrib>Compare, Angelo</creatorcontrib><creatorcontrib>Rosa, Francesco Della</creatorcontrib><creatorcontrib>Bellardita, Lara</creatorcontrib><creatorcontrib>Branzi, Giovanna</creatorcontrib><creatorcontrib>Molinari, Enrico</creatorcontrib><creatorcontrib>Parati, Gianfranco</creatorcontrib><title>Clinical and psychological telemonitoring and telecare of high risk heart failure patients</title><title>Journal of telemedicine and telecare</title><addtitle>J Telemed Telecare</addtitle><description>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 regular acquisition of simple clinical information and the possibility for the patient to contact the clinical staff improved drug titration, produced better psychological status and quality of life, and reduced hospitalizations for heart failure.</description><subject>Aftercare - methods</subject><subject>Aged</subject><subject>Analysis of Variance</subject><subject>Anxiety - etiology</subject><subject>Delivery of Health Care, Integrated - methods</subject><subject>Depressive Disorder - etiology</subject><subject>Disease Management</subject><subject>Female</subject><subject>Health Care Costs</subject><subject>Heart Failure - economics</subject><subject>Heart Failure - psychology</subject><subject>Heart Failure - therapy</subject><subject>Home Care Services, Hospital-Based</subject><subject>Humans</subject><subject>Male</subject><subject>Monitoring, Ambulatory - methods</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>Quality of Life</subject><subject>Telemedicine - economics</subject><issn>1357-633X</issn><issn>1758-1109</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kL1PwzAQxS0EoqWwM6GMLAGfHdvJiCq-pEosICGWyHXsxCWNg50M_e9xP2BAYrrTvd893T2ELgHfAAhxC5QJTuk7ZIwxnmVHaAqC5SkALo5jH-V0q0_QWQgrjEkEi1M0IYzSglMyRR_z1nZWyTaRXZX0YaMa17p6Nxl0q9eus4Pztqt3wHakpNeJM0lj6ybxNnwmjZZ-SIy07RilXg5Wd0M4RydGtkFfHOoMvT3cv86f0sXL4_P8bpEqSsWQMiK4AWLi_ZUAXNECsgxyzatcFUVRGQIkX2ZYYMYMJ4wAj6fzTFAw2ChJZ-h679t79zXqMJRrG5RuW9lpN4YSOGUYcwxZRPEeVd6F4LUpe2_X0m9KwOU20fJvonHl6uA-Lte6-l34iTAC6R4Istblyo2-i9_-b_gNilZ9EQ</recordid><startdate>20141201</startdate><enddate>20141201</enddate><creator>Villani, Alessandra</creator><creator>Malfatto, Gabriella</creator><creator>Compare, Angelo</creator><creator>Rosa, Francesco Della</creator><creator>Bellardita, Lara</creator><creator>Branzi, Giovanna</creator><creator>Molinari, Enrico</creator><creator>Parati, Gianfranco</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20141201</creationdate><title>Clinical and psychological telemonitoring and telecare of high risk heart failure patients</title><author>Villani, Alessandra ; Malfatto, Gabriella ; Compare, Angelo ; Rosa, Francesco Della ; Bellardita, Lara ; Branzi, Giovanna ; Molinari, Enrico ; Parati, Gianfranco</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-5276f12f564d710d3914418e6d8c999df2128b407055f62521696364731f0fca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aftercare - methods</topic><topic>Aged</topic><topic>Analysis of Variance</topic><topic>Anxiety - etiology</topic><topic>Delivery of Health Care, Integrated - methods</topic><topic>Depressive Disorder - etiology</topic><topic>Disease Management</topic><topic>Female</topic><topic>Health Care Costs</topic><topic>Heart Failure - economics</topic><topic>Heart Failure - psychology</topic><topic>Heart Failure - therapy</topic><topic>Home Care Services, Hospital-Based</topic><topic>Humans</topic><topic>Male</topic><topic>Monitoring, Ambulatory - methods</topic><topic>Patient Readmission - statistics & numerical data</topic><topic>Quality of Life</topic><topic>Telemedicine - economics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Villani, Alessandra</creatorcontrib><creatorcontrib>Malfatto, Gabriella</creatorcontrib><creatorcontrib>Compare, Angelo</creatorcontrib><creatorcontrib>Rosa, Francesco Della</creatorcontrib><creatorcontrib>Bellardita, Lara</creatorcontrib><creatorcontrib>Branzi, Giovanna</creatorcontrib><creatorcontrib>Molinari, Enrico</creatorcontrib><creatorcontrib>Parati, Gianfranco</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of telemedicine and telecare</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Villani, Alessandra</au><au>Malfatto, Gabriella</au><au>Compare, Angelo</au><au>Rosa, Francesco Della</au><au>Bellardita, Lara</au><au>Branzi, Giovanna</au><au>Molinari, Enrico</au><au>Parati, Gianfranco</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical and psychological telemonitoring and telecare of high risk heart failure patients</atitle><jtitle>Journal of telemedicine and telecare</jtitle><addtitle>J Telemed Telecare</addtitle><date>2014-12-01</date><risdate>2014</risdate><volume>20</volume><issue>8</issue><spage>468</spage><epage>475</epage><pages>468-475</pages><issn>1357-633X</issn><eissn>1758-1109</eissn><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 regular acquisition of simple clinical information and the possibility for the patient to contact the clinical staff improved drug titration, produced better psychological status and quality of life, and reduced hospitalizations for heart failure.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>25339632</pmid><doi>10.1177/1357633X14555644</doi><tpages>8</tpages></addata></record> |
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| ispartof | Journal of telemedicine and telecare, 2014-12, Vol.20 (8), p.468-475 |
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| source | SAGE Complete A-Z List; MEDLINE |
| subjects | Aftercare - methods Aged Analysis of Variance Anxiety - etiology Delivery of Health Care, Integrated - methods Depressive Disorder - etiology Disease Management Female Health Care Costs Heart Failure - economics Heart Failure - psychology Heart Failure - therapy Home Care Services, Hospital-Based Humans Male Monitoring, Ambulatory - methods Patient Readmission - statistics & numerical data Quality of Life Telemedicine - economics |
| title | Clinical and psychological telemonitoring and telecare of high risk heart failure patients |
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