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April 24, 2026Open Access

Effectiveness of telemonitoring on clinical outcomes in patients with heart failure: a randomized clinical trial

Key Points

To assess the effectiveness of telemonitoring on clinical outcomes in heart failure patients.
Conducted a parallel randomized clinical trial with blinded assessments

Structured PICO

Does structured telemonitoring and education improve self-care and medication adherence in patients with heart failure?

Population

136 adults (age 18-80 years) with chronic heart failure (NYHA class II-III), recruited from 2 hospitals in Tehran, Iran. Key inclusion: access to the Internet and a smartphone with confirmed ability to use it. Key exclusions: other chronic disorders such as cancer, depression, mental disability, or vision/hearing problems.

Intervention

Structured telemonitoring, education, and weekly follow-up for 8 weeks. Included weekly educational content (written and audio) via the 'Bale' messaging platform, weekly Q&A, and weekly follow-up phone calls to monitor symptoms (shortness of breath, weight gain, edema, etc.) and vital signs.

Comparator

Standard care consisting of brief, unstructured verbal instructions from nurses or physicians at the time of hospitalization or discharge, covering general topics without structured educational materials, messaging, or systematic weekly follow-up.

Outcome

Self-care measured using the European Heart Failure Self-Care Behavior Scale (EHFSCBS) at 4 weeks post-intervention.patient reported

An 8-week structured telemonitoring and education program significantly improved self-care behaviors and medication adherence in patients with heart failure compared to standard care.

Abstract

Given the advancements in information technology in recent years, there is a possibility of implementing technology-based interventions to train, monitor clinical outcomes, and improve patients with heart failure (HF) ‘s self-care abilities. This study was conducted to determine the effectiveness of telemonitoring on clinical outcomes of patients with HF. In this parallel randomized clinical trial with blinded outcome assessment and data analysis, 136 patients with HF were allocated to intervention or control groups. The intervention group received structured telemonitoring, education, and weekly follow-up for eight weeks. Self-care (primary outcome) was measured using the European Heart Failure Self-Care Behavior Scale, and medication adherence (secondary outcome) was assessed using the Medication Adherence Rating Scale at baseline and four weeks post-intervention. A total of 136 patients were enrolled, and 123 completed the study (intervention = 61; control = 62). Baseline demographic characteristics and outcome measures were comparable between the two groups. Following the intervention, self-care scores significantly improved in the intervention group compared with the control group (p < 0.001), with a large effect size (Cohen’s d = − 1.26; 95% CI − 1.64 to − 0.87). Medication adherence also showed a significant improvement in the intervention group compared with the control group after adjusting for baseline values (p < 0.001), with a moderate-to-large effect size (Cohen’s d = 0.73; 95% CI 0.37 to 1.10). Structured telemonitoring was associated with improvements in self-care and medication adherence in patients with HF. These findings suggest that technology-based follow-up programs may support better patient engagement and clinical outcomes. Further studies are needed to confirm the long-term benefits and sustainability of these interventions. Trial Registration: IRCT20230221057476N1 (Date 28/06/2023).

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Cite This Study

Shahbazi et al. (Wed,) studied this question.

synapsesocial.com/papers/69eb0a66553a5433e34b46bb https://doi.org/https://doi.org/10.1038/s41598-026-49399-x

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