Home telemonitoring of vital signs and cardiorespiratory signals in heart failure patients: system architecture and feasibility of the HHH model.

BACKGROUND: The Home or Hospital in Heart Failure Study (HHH) is a European Community funded trial (QLGA-CT-2001-02424) which compares usual care of heart failure (HF) with three home-based interventions in a multicenter, multicountry (Italy, Poland and UK), randomized controlled clinical trial. Ho...

Full description

Bibliographic Details
Main Authors: Pinna, G, Maestri, R, Andrews, D, Witkowski, T, Capomolla, S, Scanferlato, J, Gobbi, E, Ferrari, M, Ponikowski, P, Sleight, P, Mortara, A, Johnson, P
Format: Journal article
Language:English
Published: 2007
_version_ 1826291745676066816
author Pinna, G
Maestri, R
Andrews, D
Witkowski, T
Capomolla, S
Scanferlato, J
Gobbi, E
Ferrari, M
Ponikowski, P
Sleight, P
Mortara, A
Johnson, P
author_facet Pinna, G
Maestri, R
Andrews, D
Witkowski, T
Capomolla, S
Scanferlato, J
Gobbi, E
Ferrari, M
Ponikowski, P
Sleight, P
Mortara, A
Johnson, P
author_sort Pinna, G
collection OXFORD
description BACKGROUND: The Home or Hospital in Heart Failure Study (HHH) is a European Community funded trial (QLGA-CT-2001-02424) which compares usual care of heart failure (HF) with three home-based interventions in a multicenter, multicountry (Italy, Poland and UK), randomized controlled clinical trial. Home telemonitoring (HT) of clinical parameters represents a potential alternative (or addition) to traditional home care models. Nocturnal respiratory disorders (periodic breathing, sleep apnea) are very common in HF, and are associated with increased morbidity and mortality. We developed an integrated HT system for monitoring of both vital signs and respiration. All measurements were patient-managed. This paper describes the architecture of this system, and assesses its feasibility. METHODS AND RESULTS: 461 clinically stable patients were randomized first to usual vs home-monitored care; the latter were further randomized to 3 strategies. Over a 12-month follow-up 2 of these 3 groups (195 patients, age: 60+/-11 years, NYHA class II-III: 97%, LVEF 28+/-7%) underwent self-administered home monitoring of vital signs (weekly--12 parameters using an interactive voice response system) and respiration (monthly--24-hour recording). Data were transmitted over conventional telephone lines; 81% of actually practicable vital signs measurements were completed by the patients (range: 75% (PL)-93% (UK)), as well as 92% of practicable respiratory recordings (range: 85% (PL)-99% (UK)). 87% of nighttime recordings were eligible for the study (good quality signals for > or = 2.5 h). CONCLUSIONS: This study, the largest so far, demonstrates that self-managed home telemonitoring of both vital signs and respiration is feasible in HF patients, with surprisingly high compliance. We found an excellent rate of acceptable nocturnal respiratory recordings, which are those with the greatest clinical relevance.
first_indexed 2024-03-07T03:04:03Z
format Journal article
id oxford-uuid:b1ea7255-36b4-432c-b902-4dd9cb9329e7
institution University of Oxford
language English
last_indexed 2024-03-07T03:04:03Z
publishDate 2007
record_format dspace
spelling oxford-uuid:b1ea7255-36b4-432c-b902-4dd9cb9329e72022-03-27T04:07:43ZHome telemonitoring of vital signs and cardiorespiratory signals in heart failure patients: system architecture and feasibility of the HHH model.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:b1ea7255-36b4-432c-b902-4dd9cb9329e7EnglishSymplectic Elements at Oxford2007Pinna, GMaestri, RAndrews, DWitkowski, TCapomolla, SScanferlato, JGobbi, EFerrari, MPonikowski, PSleight, PMortara, AJohnson, P BACKGROUND: The Home or Hospital in Heart Failure Study (HHH) is a European Community funded trial (QLGA-CT-2001-02424) which compares usual care of heart failure (HF) with three home-based interventions in a multicenter, multicountry (Italy, Poland and UK), randomized controlled clinical trial. Home telemonitoring (HT) of clinical parameters represents a potential alternative (or addition) to traditional home care models. Nocturnal respiratory disorders (periodic breathing, sleep apnea) are very common in HF, and are associated with increased morbidity and mortality. We developed an integrated HT system for monitoring of both vital signs and respiration. All measurements were patient-managed. This paper describes the architecture of this system, and assesses its feasibility. METHODS AND RESULTS: 461 clinically stable patients were randomized first to usual vs home-monitored care; the latter were further randomized to 3 strategies. Over a 12-month follow-up 2 of these 3 groups (195 patients, age: 60+/-11 years, NYHA class II-III: 97%, LVEF 28+/-7%) underwent self-administered home monitoring of vital signs (weekly--12 parameters using an interactive voice response system) and respiration (monthly--24-hour recording). Data were transmitted over conventional telephone lines; 81% of actually practicable vital signs measurements were completed by the patients (range: 75% (PL)-93% (UK)), as well as 92% of practicable respiratory recordings (range: 85% (PL)-99% (UK)). 87% of nighttime recordings were eligible for the study (good quality signals for > or = 2.5 h). CONCLUSIONS: This study, the largest so far, demonstrates that self-managed home telemonitoring of both vital signs and respiration is feasible in HF patients, with surprisingly high compliance. We found an excellent rate of acceptable nocturnal respiratory recordings, which are those with the greatest clinical relevance.
spellingShingle Pinna, G
Maestri, R
Andrews, D
Witkowski, T
Capomolla, S
Scanferlato, J
Gobbi, E
Ferrari, M
Ponikowski, P
Sleight, P
Mortara, A
Johnson, P
Home telemonitoring of vital signs and cardiorespiratory signals in heart failure patients: system architecture and feasibility of the HHH model.
title Home telemonitoring of vital signs and cardiorespiratory signals in heart failure patients: system architecture and feasibility of the HHH model.
title_full Home telemonitoring of vital signs and cardiorespiratory signals in heart failure patients: system architecture and feasibility of the HHH model.
title_fullStr Home telemonitoring of vital signs and cardiorespiratory signals in heart failure patients: system architecture and feasibility of the HHH model.
title_full_unstemmed Home telemonitoring of vital signs and cardiorespiratory signals in heart failure patients: system architecture and feasibility of the HHH model.
title_short Home telemonitoring of vital signs and cardiorespiratory signals in heart failure patients: system architecture and feasibility of the HHH model.
title_sort home telemonitoring of vital signs and cardiorespiratory signals in heart failure patients system architecture and feasibility of the hhh model
work_keys_str_mv AT pinnag hometelemonitoringofvitalsignsandcardiorespiratorysignalsinheartfailurepatientssystemarchitectureandfeasibilityofthehhhmodel
AT maestrir hometelemonitoringofvitalsignsandcardiorespiratorysignalsinheartfailurepatientssystemarchitectureandfeasibilityofthehhhmodel
AT andrewsd hometelemonitoringofvitalsignsandcardiorespiratorysignalsinheartfailurepatientssystemarchitectureandfeasibilityofthehhhmodel
AT witkowskit hometelemonitoringofvitalsignsandcardiorespiratorysignalsinheartfailurepatientssystemarchitectureandfeasibilityofthehhhmodel
AT capomollas hometelemonitoringofvitalsignsandcardiorespiratorysignalsinheartfailurepatientssystemarchitectureandfeasibilityofthehhhmodel
AT scanferlatoj hometelemonitoringofvitalsignsandcardiorespiratorysignalsinheartfailurepatientssystemarchitectureandfeasibilityofthehhhmodel
AT gobbie hometelemonitoringofvitalsignsandcardiorespiratorysignalsinheartfailurepatientssystemarchitectureandfeasibilityofthehhhmodel
AT ferrarim hometelemonitoringofvitalsignsandcardiorespiratorysignalsinheartfailurepatientssystemarchitectureandfeasibilityofthehhhmodel
AT ponikowskip hometelemonitoringofvitalsignsandcardiorespiratorysignalsinheartfailurepatientssystemarchitectureandfeasibilityofthehhhmodel
AT sleightp hometelemonitoringofvitalsignsandcardiorespiratorysignalsinheartfailurepatientssystemarchitectureandfeasibilityofthehhhmodel
AT mortaraa hometelemonitoringofvitalsignsandcardiorespiratorysignalsinheartfailurepatientssystemarchitectureandfeasibilityofthehhhmodel
AT johnsonp hometelemonitoringofvitalsignsandcardiorespiratorysignalsinheartfailurepatientssystemarchitectureandfeasibilityofthehhhmodel