Combined telemonitoring and telecoaching for heart failure improves outcome
Abstract Telemedicine has been shown to improve the outcome of heart failure (HF) patients in addition to medical and device therapy. We investigate the effectiveness of a comprehensive telehealth programme in patients with recent hospitalisation for HF on subsequent HF hospitalisations and mortalit...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2023-10-01
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| Series: | npj Digital Medicine |
| Online Access: | https://doi.org/10.1038/s41746-023-00942-4 |
| _version_ | 1797556259972448256 |
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| author | Katharina Knoll Stefanie Rosner Stefan Gross Dino Dittrich Carsten Lennerz Teresa Trenkwalder Stefanie Schmitz Stefan Sauer Christian Hentschke Marcus Dörr Christian Kloss Heribert Schunkert Wibke Reinhard |
| author_facet | Katharina Knoll Stefanie Rosner Stefan Gross Dino Dittrich Carsten Lennerz Teresa Trenkwalder Stefanie Schmitz Stefan Sauer Christian Hentschke Marcus Dörr Christian Kloss Heribert Schunkert Wibke Reinhard |
| author_sort | Katharina Knoll |
| collection | DOAJ |
| description | Abstract Telemedicine has been shown to improve the outcome of heart failure (HF) patients in addition to medical and device therapy. We investigate the effectiveness of a comprehensive telehealth programme in patients with recent hospitalisation for HF on subsequent HF hospitalisations and mortality compared to usual care in a real-world setting. The telehealth programme consists of daily remote telemonitoring of HF signs/symptoms and regular individualised telecoaching sessions. Between January 2018 and September 2020, 119,715 patients of a German health insurer were hospitalised for HF and were eligible for participation in the programme. Finally, 6065 HF patients at high risk for re-hospitalisation were enroled. Participants were retrospectively compared to a propensity score matched usual care group (n = 6065). Median follow-up was 442 days (IQR 309–681). Data from the health insurer was used to evaluate outcomes. After one year, the number of hospitalisations for HF (17.9 vs. 21.8 per 100 patient years, p < 0.001), all-cause hospitalisations (129.0 vs. 133.2 per 100 patient years, p = 0.015), and the respective days spent in hospital (2.0 vs. 2.6 days per year, p < 0.001, and 12.0 vs. 13.4, p < 0.001, respectively) were significantly lower in the telehealth than in the usual care group. Moreover, participation in the telehealth programme was related to a significant reduction in all-cause mortality compared to usual care (5.8 vs. 11.0 %, p < 0.001). In a real-life setting of ambulatory HF patients at high risk for re-hospitalisation, participation in a comprehensive telehealth programme was related to a reduction of HF hospitalisations and all-cause mortality compared to usual care. |
| first_indexed | 2024-03-10T17:00:18Z |
| format | Article |
| id | doaj.art-d3c6667e6e674487b177de574543c6b6 |
| institution | Directory Open Access Journal |
| issn | 2398-6352 |
| language | English |
| last_indexed | 2024-03-10T17:00:18Z |
| publishDate | 2023-10-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | npj Digital Medicine |
| spelling | doaj.art-d3c6667e6e674487b177de574543c6b62023-11-20T11:00:46ZengNature Portfolionpj Digital Medicine2398-63522023-10-01611910.1038/s41746-023-00942-4Combined telemonitoring and telecoaching for heart failure improves outcomeKatharina Knoll0Stefanie Rosner1Stefan Gross2Dino Dittrich3Carsten Lennerz4Teresa Trenkwalder5Stefanie Schmitz6Stefan Sauer7Christian Hentschke8Marcus Dörr9Christian Kloss10Heribert Schunkert11Wibke Reinhard12German Heart Centre Munich, Department of Cardiology, Technical University MunichGerman Heart Centre Munich, Department of Cardiology, Technical University MunichDepartment of Internal Medicine B, University Medicine GreifswaldHealth Care Systems GmbH (HCSG)German Heart Centre Munich, Department of Cardiology, Technical University MunichGerman Heart Centre Munich, Department of Cardiology, Technical University MunichKrankenkasse KNAPPSCHAFTNovartis Pharma GmbHNovartis Pharma GmbHDepartment of Internal Medicine B, University Medicine GreifswaldHealth Care Systems GmbH (HCSG)German Heart Centre Munich, Department of Cardiology, Technical University MunichGerman Heart Centre Munich, Department of Cardiology, Technical University MunichAbstract Telemedicine has been shown to improve the outcome of heart failure (HF) patients in addition to medical and device therapy. We investigate the effectiveness of a comprehensive telehealth programme in patients with recent hospitalisation for HF on subsequent HF hospitalisations and mortality compared to usual care in a real-world setting. The telehealth programme consists of daily remote telemonitoring of HF signs/symptoms and regular individualised telecoaching sessions. Between January 2018 and September 2020, 119,715 patients of a German health insurer were hospitalised for HF and were eligible for participation in the programme. Finally, 6065 HF patients at high risk for re-hospitalisation were enroled. Participants were retrospectively compared to a propensity score matched usual care group (n = 6065). Median follow-up was 442 days (IQR 309–681). Data from the health insurer was used to evaluate outcomes. After one year, the number of hospitalisations for HF (17.9 vs. 21.8 per 100 patient years, p < 0.001), all-cause hospitalisations (129.0 vs. 133.2 per 100 patient years, p = 0.015), and the respective days spent in hospital (2.0 vs. 2.6 days per year, p < 0.001, and 12.0 vs. 13.4, p < 0.001, respectively) were significantly lower in the telehealth than in the usual care group. Moreover, participation in the telehealth programme was related to a significant reduction in all-cause mortality compared to usual care (5.8 vs. 11.0 %, p < 0.001). In a real-life setting of ambulatory HF patients at high risk for re-hospitalisation, participation in a comprehensive telehealth programme was related to a reduction of HF hospitalisations and all-cause mortality compared to usual care.https://doi.org/10.1038/s41746-023-00942-4 |
| spellingShingle | Katharina Knoll Stefanie Rosner Stefan Gross Dino Dittrich Carsten Lennerz Teresa Trenkwalder Stefanie Schmitz Stefan Sauer Christian Hentschke Marcus Dörr Christian Kloss Heribert Schunkert Wibke Reinhard Combined telemonitoring and telecoaching for heart failure improves outcome npj Digital Medicine |
| title | Combined telemonitoring and telecoaching for heart failure improves outcome |
| title_full | Combined telemonitoring and telecoaching for heart failure improves outcome |
| title_fullStr | Combined telemonitoring and telecoaching for heart failure improves outcome |
| title_full_unstemmed | Combined telemonitoring and telecoaching for heart failure improves outcome |
| title_short | Combined telemonitoring and telecoaching for heart failure improves outcome |
| title_sort | combined telemonitoring and telecoaching for heart failure improves outcome |
| url | https://doi.org/10.1038/s41746-023-00942-4 |
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