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The effect of telehealth, telephone support or usual care on quality of life, mortality and healthcare utilization in elderly high-risk patients with multiple chronic conditions. A prospective study / Telecuidados, apoyo telefónico o cuidados habituales: impacto sobre la calidad de vida, mortalidad y uso de recursos sanitarios en pacientes ancianos de alto riesgo con múltiples condiciones crónicas. Un estudio prospectivo

Med. clín (Ed. impr.); 151(8): 308-314, oct. 2018. tab, graf
Artigo em Inglês | IBECS - ES | ID: ibc-174000


To assess the effect of home based telehealth or structured telephone support interventions with respect to usual care on quality of life, mortality and healthcare utilization in elderly high-risk multiple chronic condition patients.


472 elderly high-risk patients with plurimorbidity in the region of Valencia (Spain) were recruited between June 2012 and May 2013, and followed for 12 months from recruitment. Patients were allocated to either: (a) a structured telephone intervention, a nurse-led case management program with telephone follow up every 15 days; (b) telehealth, which adds technology for remote self-management and the exchange of clinical data; or (c) usual care. Main outcome measures was quality of life measured by the EuroQol (EQ-5D) instrument, cognitive impairment, functional status, mortality and healthcare resource use. Inadequate randomization process led us to used propensity scores for adjusted analyses to control for imbalances between groups at baseline.


EQ-5D score was significantly higher in the telehealth group compared to usual care (diff: 0.19, 0.08–0.30), but was not different to telephone support (diff: 0.04, −0.05 to 0.14). In adjusted analyses, inclusion in the telehealth group was associated with an additional 0.18 points in the EQ-5D score compared to usual care at 12 months (p<0.001), and with a gain of 0.13 points for the telephone support group (p<0.001). No differences in mortality or utilization were found, except for a borderline significant increase in General Practitioner visits.


Telehealth was associated with better quality of life. Important limitations of the study and similarity of effects to telephone intervention call for careful endorsement of telemedicine. (identifier: NCT02447562)
Biblioteca responsável: ES1.1
Localização: BNCS