If home telemonitoring reduces mortality in heart failure, is this just due to better guideline-based treatment?

Journal of Telemedicine and Telecare
Riet DierckxAndrew L Clark

Abstract

To investigate, in a 'real-world' setting, the impact of home telemonitoring (HTM) compared to usual care on achieved dose of guideline-recommended medication, hospitalisation rate and mortality in patients with heart failure (HF). We retrospectively analyzed data on 333 patients with HF referred to a HTM service supported by a nurse-specialist (mean age 71±12 years, mean left ventricular ejection fraction (LVEF) 36 ± 11% and median N-Terminal pro B-type Natriuretic Peptide (NT-proBNP) 2,972 ng/L (interquartile range (IQR): 1,447-7,801 ng/L)). Most patients (n = 278) accepted HTM (HTM-group) but 55 refused and received usual care (UC-group). In the HTM-group, weight, heart rate, blood pressure and symptom severity were measured daily. At referral, respectively 90%, 90%, 67% and 94% of patients with LVEF ≤40% (n = 229) were treated with β-blockers (BB), angiotensin converting enzyme-inhibitors (ACE-I) or angiotensin receptor blockers (ARB), mineralocorticoid receptor antagonists (MRA) and diuretics, with rates similar between groups. After 6 months, prescription of BB (92% vs 83%), ACE-I/ARB (92% vs 90%) and MRA (68% vs 67%) did not differ significantly between groups. The proportions of patients who achieved ≥50% and ≥100% of t...Continue Reading

References

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Citations

Dec 26, 2015·Journal of Telemedicine and Telecare·Antonio D'OnofrioUNKNOWN EFFECT study investigators
Jun 30, 2016·European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology·Amanda Crundall-GoodeAndrew L Clark
Dec 15, 2019·BMC Palliative Care·Sophie HancockAmy Gadoud
Oct 24, 2019·Kardiologiia·Yu V MareevO M Drapkina

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