A randomized trial of home telemonitoring in a typical elderly heart failure population in North West London: results of the Home-HF study

被引:108
作者
Dar, Owais [1 ,2 ]
Riley, Jillian [1 ,2 ]
Chapman, Callum [3 ]
Dubrey, Simon W.
Morris, Stephen [4 ]
Rosen, Stuart D. [1 ,5 ]
Roughton, Michael [2 ]
Cowie, Martin R. [1 ,2 ]
机构
[1] Univ London Imperial Coll Sci Technol & Med, Natl Heart & Lung Inst, London SW3 6LY, England
[2] Royal Brompton & Harefield NHS Trust, London, England
[3] W Middlesex Hosp NHS Trust, Middlesex, England
[4] Brunel Univ, Hlth Econ Res Grp, Uxbridge, Middx, England
[5] Ealing Hosp NHS Trust, London, England
关键词
Heart failure; Telemonitoring; Disease management; MONITORING-SYSTEM; HIGH-RISK; MANAGEMENT; DIAGNOSIS; PROGRAM; CARE; HOSPITALIZATION; ADMISSION; MODERATE;
D O I
10.1093/eurjhf/hfn050
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims Heart failure chiefly affects the elderly, with frequent emergency admissions. Telemonitoring can identify worsening heart failure but previous randomized trials have enrolled selected patient populations. The Home-HF study examined the impact of home telemonitoring on typical heart failure patients discharged from three acute hospitals in North West London, UK. Methods and results Patients hospitalized with heart failure were randomized to telemonitoring or usual specialist care. Primary outcome measures were days alive and out of hospital. Secondary outcome measures were number and duration of heart failure hospitalizations, clinic visits, and quality of life. We recruited 182 patients. There was no difference in the primary outcome measure in the two groups, but there were significantly fewer unplanned hospitalizations for heart failure decompensation, and a reduction in clinic and emergency room visits in the telemonitoring group. There was no statistically significant difference in the mean direct health service costs. Conclusion Home telemonitoring in a typical elderly population of heart failure patients produces a similar outcome to 'usual' specialist care, but reduces clinic and emergency room visits and unplanned heart failure rehospitalizations at little additional cost. This method of disease monitoring may allow specialist services to increase the number of patients under their care.
引用
收藏
页码:319 / 325
页数:7
相关论文
共 27 条
[1]  
[Anonymous], 2008, NHS REF COSTS
[2]   Outcome of heart failure with preserved ejection fraction in a population-based study [J].
Bhatia, R. Sacha ;
Tu, Jack V. ;
Lee, Douglas S. ;
Austin, Peter C. ;
Fang, Jiming ;
Haouzi, Annick ;
Gong, Yanyan ;
Liu, Peter P. .
NEW ENGLAND JOURNAL OF MEDICINE, 2006, 355 (03) :260-269
[3]  
BONDMASS M, 2000, INTERNET J ADV NURSI, V3, pN2
[4]   Telemonitoring or structured telephone support programmes for patients with chronic heart failure: systematic review and meta-analysis [J].
Clark, Robyn A. ;
Inglis, Sally C. ;
McAlister, Finlay A. ;
Cleland, John G. F. ;
Stewart, Simon .
BMJ-BRITISH MEDICAL JOURNAL, 2007, 334 (7600) :942-945
[5]   Noninvasive home telemonitoring for patients with heart failure at high risk of recurrent admission and death - The trans-European network-home-care management system (TEN-HMS) study [J].
Cleland, JGF ;
Louis, AA ;
Rigby, AS ;
Janssens, U ;
Balk, AHMM .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2005, 45 (10) :1654-1664
[6]   The EuroHeart Failure survey programme - a survey on the quality of care among patients with heart failure in Europe - Part 1: patient characteristics and diagnosis [J].
Cleland, JGF ;
Swedberg, K ;
Follath, F ;
Komajda, M ;
Cohen-Solal, A ;
Aguilar, JC ;
Dietz, R ;
Gavazzi, A ;
Hobbs, R ;
Korewicki, J ;
Madeira, HC ;
Moiseyev, VS ;
Preda, I ;
van Gilst, WH ;
Widimsky, J ;
Freemantle, N ;
Eastaugh, J ;
Mason, J .
EUROPEAN HEART JOURNAL, 2003, 24 (05) :442-463
[7]   Use of telemonitoring to decrease the rate of hospitalization in patients with severe congestive heart failure [J].
Cordisco, ME ;
Beniaminovitz, A ;
Hammond, K ;
Mancini, D .
AMERICAN JOURNAL OF CARDIOLOGY, 1999, 84 (07) :860-+
[8]  
CURTIS I, 2008, UNIT COSTS HLTH SOCI
[9]   ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008 [J].
Dickstein, Kenneth ;
Cohen-Solal, Alain ;
Filippatos, Gerasimos ;
McMurray, John J. V. ;
Ponikowski, Piotr ;
Poole-Wilson, Philip Alexander ;
Stromberg, Anna ;
van Veldhuisen, Dirk J. ;
Atar, Dan ;
Hoes, Arno W. ;
Keren, Andre ;
Mebazaa, Alexandre ;
Nieminen, Markku ;
Priori, Silvia Giuliana ;
Swedberg, Karl .
EUROPEAN HEART JOURNAL, 2008, 29 (19) :2388-2442
[10]   Feasibility of a nurse-monitored, outpatient-care programme for elderly patients with moderate-to-severe, chronic heart failure [J].
Ekman, I ;
Andersson, B ;
Ehnfors, M ;
Matejka, G ;
Persson, B ;
Fagerberg, B .
EUROPEAN HEART JOURNAL, 1998, 19 (08) :1254-1260