Association of a Remote Monitoring Programme with All-Cause Mortality and Hospitalizations in Patients with Heart Failure: National-Scale, Real-World Evidence from a 3-Year Propensity Score Analysis of the TELESAT-HF Study

AIMS: To examine the association of a remote monitoring programme (RMP) with all-cause mortality and hospital admissions for heart failure (HF) within the French healthcare system. METHODS AND RESULTS: A national-scale, real-world, propensity-weighted cohort study was conducted using the SNDS French database from August 2018 to December 2022 (NCT06312501). Patients receiving standard of care (SoC) were compared with those receiving RMP (Satelia® Cardio, NP Medical). The Satelia® Cardio algorithm adjusted the monitoring frequency based on symptom and weight changes, and provided tailored web-based patient education. The RMP included a digital interface for proficient patients and phone monitoring by nurses for those uncomfortable with digital technology. Data were sourced from over 300 healthcare centres across France. A propensity-weighted Cox regression model was used, supplemented by sensitivity analyses across subgroups. In total, 5357 RMP patients and 13 525 SoC patients were included after weighting. Weighted/adjusted analyses showed lower all-cause mortality for RMP patients (hazard ratio HR 0.64; 95% confidence interval CI 0.59-0.70; p < 0.0001), persisting across hospitalization and/or long-term illness status subgroups (HR 0.52 to 0.75). RMP was neutrally associated with HF hospitalization rates (rate ratio RR 0.95; 95% CI 0.89-1.02) but linked to less time in hospital (-2.1%, p < 0.0001) and fewer emergency visits (RR 0.83; 95% CI 0.75-0.92; p = 0.001). CONCLUSION: In France, RMP with customized monitoring frequencies and educational strategies was associated with lower all-cause mortality, emergency visits, and time spent in hospital in patients with HF which may enhance nationwide HF management.