What question did this study set out to answer?

To evaluate the impact of home-based telemonitoring via mobile phone technology on clinical outcomes in heart failure patients following an episode of acute decompensation.

August 17, 2009Journal of Medical Internet ResearchOpen Access

Effect of Home-Based Telemonitoring Using Mobile Phone Technology on the Outcome of Heart Failure Patients After an Episode of Acute Decompensation: Randomized Controlled Trial

View Full Paper

Ask AI

Bookmark

Why the study?

Does home-based telemonitoring using mobile phone technology reduce hospitalization for worsening CHF or cardiovascular death in patients with chronic heart failure after an episode of acute decompensation?

Population

120 patients with chronic heart failure after an episode of acute decompensation, median age 66 years, 85…

Comparison

Home-based telemonitoring using mobile phone… vs Pharmacological treatment alone (control group).

Design

RCT, randomly allocated

Follow-up

6 months

Authors

PKPeter KästnerUniversity of Vienna AKA. KollmannSalzburger Landeskliniken AHAndreas HallasUniversitätsklinikum Tulln

Discussion

Member takes

Implication

Trend toward fewer events (P=.06) does not support routine adoption; leaves open efficacy after HF decompensation pending larger trials.

Key Points

To evaluate the impact of home-based telemonitoring via mobile phone technology on clinical outcomes in heart failure patients following an episode of acute decompensation.
Randomized controlled trial allocating 120 patients after acute decompensation to standard pharmacological treatment (control group, n=54) or pharmacological treatment with 6 months of telemedical surveillance (tele group, n=54).
Telemonitoring participants transmitted health data using mobile phone terminals to a secure portal, generating automatic email alerts to study physicians if readings breached individualized thresholds.
The primary endpoint was hospitalization for worsening chronic heart failure or death from cardiovascular causes.
Intention-to-treat analysis showed primary endpoint events in 33% of controls (18/54) versus 17% of telemonitoring patients (11/54; relative risk reduction 50%, 95% CI 3–74%, P = .06); per-protocol relative risk reduction was 54% (15% vs 33%, 95% CI 7–79%, P = .04).
Hospitalized telemonitoring patients experienced a significantly shorter median length of stay (6.5 days, IQR 5.5–8.3) compared to control patients (10.0 days, IQR 7.0–13.0; P = .04).
NYHA functional class improved by one full class exclusively in the telemonitoring group (P < .001), though 12 patients in this group were unable to operate the mobile terminal.

Structured PICO

Population

120 patients with chronic heart failure (CHF) after an episode of acute decompensation, median age 66 years, 85 male and 35 female.

Intervention

Home-based telemonitoring using mobile phone technology for data acquisition and transmission to a monitoring center, added to pharmacological treatment for 6 months.

Comparator

Pharmacological treatment alone (control group).

Outcome

Composite of hospitalization for worsening CHF or death from cardiovascular cause.composite

Home-based telemonitoring using mobile phones for heart failure patients after acute decompensation showed a trend toward reducing the composite of cardiovascular death or heart failure hospitalization, though usability in elderly patients remains a challenge.

Limitations

Study was stopped early after randomization of 120 patients.
12 tele group patients were unable to begin data transmission due to inability to properly operate the mobile phone.

Cite This Study

Kästner et al. (2009) studied this question.

synapsesocial.com/papers/6a7cbe681b0fae09726eeb91 https://doi.org/10.2196/jmir.1252

Topics

Heart failure HFrEF treatment Heart failure hospitalization

View Full Paper

Ask AI

Bookmark

Effect of Home-Based Telemonitoring Using Mobile Phone Technology on the Outcome of Heart Failure Patients After an Episode of Acute Decompensation: Randomized Controlled Trial

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Topics

Effect of Home-Based Telemonitoring Using Mobile Phone Technology on the Outcome of Heart Failure Patients After an Episode of Acute Decompensation: Randomized Controlled Trial

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider