Technology

Telemonitoring of patients with heart failure reduces the number of hospitalizations and deaths

A new study demonstrates the benefits of medical telemonitoring for patients with heart failure (HF). Published in the journal ESC Heart Failure and identified by Quotidien du Médecin, he concludes that this form of follow-up can significantly reduce hospitalization and death rates.

To reach this conclusion, the researchers relied on data from patients volunteering for the SCAD-ID program. Deployed in Normandy in 2009, it operates through a tablet provided to the patient, who answers questions each morning on a variety of topics. The machine learning system interprets the answers and possibly offers additional questions and advice. It generates alerts for the monitoring group as needed. For a stable patient, five minutes is sufficient. It’s a little longer when it shows warning signs. The doctor reads the data collected in this way every day.

Diligence guarantees convincing results

The researchers followed a cohort of 659 patients between 2009 and December 2016 with a mean follow-up of 32.9 months, or approximately 2 years and 7 months. Their hospitalization and mortality rates were compared according to program use (low, medium, and high). Not surprisingly, the more diligent the patients, the more convincing the results.

Overall, the rate of hospitalizations for CVD decreased from 79.4% the year before enrollment to 41.1% the following year, and from 52.2% to 18.8% for hospitalizations for heart failure. The 12-month mortality rate was 11.2%, which is lower than before using the device.

The program has also proven to be effective for patients with anxiety symptoms. Most of the alerts were generated within 24 hours, a period that would not be met if the person had to see a doctor. About half of the red or orange alerts resulted in a medical visit or hospitalization.

Long term benefits

The study also concluded that the benefits in terms of hospitalization and mortality associated with high program utilization were maintained after a three-month follow-up period. The readmission rate for HF at 1 year in moderate to severe users (12.9% and 13.5%) is lower than the 20% reported in an observational study of all patients hospitalized for HF in France during the same period .

Mortality was also lower in this population compared to French data available for HF patients in 2009 (19.3% vs. 40.3% at 2 years). These results suggest that “intensive therapeutic training during the period of SCAD telemonitoring (…) provides sustained change in patient behavior and hence sustained clinical benefits.”

The researchers note that this type of program can be “relatively easily transferred to the treatment of other chronic disabling conditions affecting older adults with limited mobility.” However, despite its many benefits, it is difficult to generalize, unfortunately the study authors. Reason: lack of personnel and computer equipment. However, from an economic point of view, the use of telemonitoring is interesting, since it allows better management of patients outside the hospital and, therefore, reduces costs.

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