A favorable response to a home-based telesurveillance program was associated with fewer 1-year cardiovascular readmissions and mortality compared to non-responders (15.9% vs 24.1%; p=0.03).
Cohort (n=602)
Does a home-based telesurveillance program improve functional status and reduce 1-year clinical events in patients with chronic heart failure?
A home-based telesurveillance program improves functional status in CHF patients, and a positive clinical response to the program predicts a lower risk of 1-year cardiovascular readmission and mortality.
Absolute Event Rate: 15.9% vs 24.1%
p-value: p=0.03
Background:Studies focusing on the effects of telemanagement programs for chronic heart failure (CHF) on functional status are lacking, and the prognostic value of the clinical response to the programs is unknown. In the Lombardy region of Italy, a home-based telesurveillance program (HTP) including multidisciplinary management and remote telemonitoring for patients with CHF was introduced in 2000 and was formally adopted, as part of the services delivered by the regional healthcare system, in 2006. This article reports the effect of the HTP on the functional status and quality of life and describes the main outcomes observed within 1 year from the end of the program.Materials and Methods:Six-month variations of New York Heart Association (NYHA) class, left ventricular ejection fraction (LVEF), 6-min walking distance (6MWD), and Minnesota Living with Heart Failure Questionnaire (MLHFQ) score were evaluated in 602 CHF patients. Patients showing at least two of the following conditions—NYHA class reduction, increase in LVEF ≥5%, 6MWD >30 m, and a reduction of >24 points of MLHFQ—were defined as “responders.” One-year events included unplanned cardiovascular readmissions and mortality.Results:A significant improvement in NYHA class, LVEF, 6MWD, and MLHFQ was observed. Clinical events occurred in 24.1% of non-responders and in 15.9% of responders (p=0.03). An unfavorable response to the program, the presence of an implantable cardioverter defibrillator, and multiple comorbidities were predictors of poor outcome.Conclusions:The HTP was effective in improving CHF patient functional status, and an unsuccessful response to the intervention seems to be an independent marker of poor prognosis.
Giordano et al. (Wed,) conducted a cohort in chronic heart failure (n=602). Favorable clinical response to home-based telesurveillance program vs. Non-responders was evaluated on 1-year events (unplanned cardiovascular readmissions and mortality) (p=0.03). A favorable response to a home-based telesurveillance program was associated with fewer 1-year cardiovascular readmissions and mortality compared to non-responders (15.9% vs 24.1%; p=0.03).