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March 28, 2013BMC Health Services ResearchOpen Access

Impact of telemonitoring home care patients with heart failure or chronic lung disease from primary care on healthcare resource use (the TELBIL study randomised controlled trial)

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Key result

Home telemonitoring significantly reduced the risk of experiencing at least one hospital admission compared to usual care (RR 0.66) in in-home patients with heart failure or chronic lung disease.

Why the study?

Does home telemonitoring reduce hospital admissions in in-home patients with heart failure or chronic lung disease?

Population

58 in-home adult patients diagnosed with heart failure and/or chronic lung disease, with a history of at…

Comparison

Home telemonitoring added to usual care for 12… vs Usual care.

Design

RCT, Randomised controlled trial

Follow-up

12 months

Authors

ILIñaki Martín LesendeEOEstibalitz OrruñoABAmaia Bilbao

Discussion

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Overview

Supports home telemonitoring to reduce admissions in elderly in-home HF or lung disease patients; extends RCT evidence for remote monitoring in chronic care.

Study Design

Type

RCT (n=58)

Blinding

Open-label

Randomization

Randomised

Multicenter

Yes

Structured PICO

Does home telemonitoring reduce hospital admissions in in-home patients with heart failure or chronic lung disease?

P
Population
58 in-home patients aged 14 or older with heart failure and/or chronic lung disease and at least two hospital admissions in the previous year, followed for 12 months.
I
Intervention
Home telemonitoring (daily self-measurements of respiratory-rate, heart-rate, blood pressure, oxygen saturation, weight, body temperature, and health status questionnaire via PDA) added to usual care for 12 months.
C
Comparator
Usual care (regular medical examinations and GP/nurse visits on demand).
O
Outcome
Number of hospital admissions at 12 months post-randomisation.hard clinical

Main Result

Relative Risk: 0.66 (95% CI 0.44–0.99)

Absolute Event Rate: 57.1% vs 86.4%

Number Needed to Treat: 4

p-value: p=0.033

Home telemonitoring significantly reduced the proportion of patients requiring hospital admission over 12 months among elderly in-home patients with heart failure or chronic lung disease.

Limitations

  • Small sample size due to recruitment limitations
  • Loss to follow-up and high mortality rate reducing statistical power
  • Recruitment limitations
  • Follow-up losses
  • Small sample size

Cite This Study

Lesende et al. (2013) conducted an RCT in Heart failure and/or chronic lung disease (n=58). Home telemonitoring vs. Usual care was evaluated on Occurrence of at least one hospital admission at 12 months post-randomisation (RR 0.66, 95% CI 0.44-0.99, p=0.033). Home telemonitoring significantly reduced the risk of experiencing at least one hospital admission compared to usual care (RR 0.66) in in-home patients with heart failure or chronic lung disease.

synapsesocial.com/papers/6a7789293da069e66cbdafa2https://doi.org/10.1186/1472-6963-13-118
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Telemonitoring of Heart Failure Patients and Their Caregivers: A Pilot Randomized Controlled Trial2008 · 106 citations
  2. 2Telemonitoring or structured telephone support programmes for patients with chronic heart failure: systematic review and meta-analysis2007 · 684 citations
  3. 3Noninvasive Home Telemonitoring for Patients With Heart Failure at High Risk of Recurrent Admission and Death2005 · 704 citations
  4. 4Concurrent and Predictive Validity of a Self-reported Measure of Medication Adherence1986 · 5,382 citations
  5. 5Assessment of a primary care-based telemonitoring intervention for home care patients with heart failure and chronic lung disease. The TELBIL study2011 · 41 citations