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17 Telemedicine in Patients with New Diagnosis of Heart Failure: From Clinical Research to Practice
  1. George Koulaouzidis1,
  2. Kevin Mohee2,
  3. David Barrett3,
  4. Andrew Clark2
  1. 1Royal Brompton Hospital
  2. 2Department of Academic Cardiology, Castle Hill Hospital
  3. 3Faculty of Health and Social Care, University of Hull

Abstract

Background Heart failure (HF) is a complex clinical syndrome associated with high mortality and high rate of hospital readmissions. Telehealth (TH) is a promising strategy for improving HF outcomes but there is an urgent need to properly identify those patients in whom a TH approach would provide benefit. The purpose of this study was to determine if TH in patients with recently diagnosed HF and ejection fraction <45%, reduces the risk of re-admission from any cause or death from any cause.

Methods A retrospective study of 124 patients (78.2% male; 68.6 ± 12.6 years; 56.5% ischaemic aetiology) who underwent TH and 345 patients (68.5% male; 70.2 ± 10.7 years; 56.3% ischaemic aetiology) who underwent the usual-care (UC), between 2009–12. All patients had a recent diagnosis of HF, NHYA class II-III and ejection fraction < 45%. The TH group were assessed by body weight, blood pressure and heart rate on a daily basis using electronic devices with automatic transfer of measured data to an online database. The follow-up period was 12 months.

Results Death from any cause occurred in 8.1% of the TH group and 19% of the UC group, p = 0.002. Readmissions for any cause occurred in 63.7% of patients in the TH group and 62.5% of patients in the UC group, p = 0.8. The number of readmissions/patients was also similar in the two groups, 1.3 ± 1.7 in the TH group and 1.4 ± 1.7 in the UC group (p = 0.9). A difference in the number of days in hospital was noted (8.1 ± 12.8 days in TH group and 9.5 ± 17.3 in UC group) but this was not statistically significant (p = 0.4). There was significant difference in the days alive and away from the hospital in the two groups: 348.3 ± 5.5 days in the TH group and 329.9 ± 4.6 days in the UC group (p = 0.008).

Conclusions In patients with a recent diagnosis of HF and reduced left ventricle systolic function, TH is associated with lower any-cause mortality. Furthermore TH has the potential to reduce number of days lost to hospitalisation and death.

  • Telemedicine
  • Heart Failure
  • New diagnosed

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