Combined telemonitoring and telecoaching for heart failure improves outcome

Figures

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  Fig. 1. Study flow. *ACRA-LoH = likelihood of hospitalisation (LoH) calculated with the adaptable, comprehensive, risk assessment methodology (ACRA) based on historical data of patients from the insurance company.

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  Fig. 2. Kaplan–Meier-plots of the all-cause mortality probability (continuous line) with 95%-confidence interval (dotted line) in the intention-to-treat-analysis. Hazard ratio 0.62, 95%-confidence interval: 0.56–0.69, p < 0.001, Wald-test. Blue line: Telehealth group (TH). Red line: Usual care group (UC).

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  Fig. 3. Competing risk curve for time to first hospitalisation with specific main diagnosis and death as competing risk in the telehealth intervention (TH) and usual care (UC) group. a Hospitalisation with main diagnosis heart failure, b Hospitalisation with main diagnosis cardiovascular disease, c All-cause hospitalisations. Blue line: Telehealth group. Red line: Usual care group.

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  Fig. 4. Differences in hospitalisations rates (per 100 patient years with 95%-confidence interval) and average length of stay for different main diagnoses of hospitalisation in telehealth (TH) versus usual care (UC) group. Solid diamonds and bold diagnoses indicate statistical significance (p < 0.05 after adjustment for multiple comparisons, Wald-test), empty diamonds statistically non-significant diagnoses (p > 0.05 after adjustment for multiple comparisons, Wald-test). The bars indicate the 95%-confidence interval for the differences.

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  Fig. 5. Self-Care Behaviour (EHFScBS-9) at start of programme (black) compared to follow-up after 1 year (blue). Values standardised to 0–100, with 100 meaning full agreement. The numbers at the top indicate the change after one year. The star indicates statistically significant differences between start of programme and 1-year follow-up with a p-value of <0.001 (paired Wilcoxon tests). Black: Start of programme. Blue: After one year. Questions: 1: I weigh myself every day, 2: If shortness of breath increases, I contact my doctor or nurse, 3: If my legs/feet are more swollen, I contact my doctor or nurse, 4: If I gain weight more than 2 kg in 7 days, I contact my doctor or nurse, 5: I limit the amount of fluids (no more than 1.5–2 litres a day), 6: If I experience fatigue, I contact my doctor or nurse, 7: I eat a low-salt diet, 8: I take my medication as prescribed, 9: I exercise regularly.