Impact of telemedicine on the clinical outcomes and healthcare costs of patients with chronic heart failure and mid-range or preserved ejection fraction managed in a multidisciplinary chronic heart failure programme: A sub-analysis of the iCOR randomized trial.
J Telemed Telecare
; 26(1-2): 64-72, 2020.
Article
em En
| MEDLINE
| ID: mdl-30193564
ABSTRACT
Background:
The efficacy of telemedicine in the management of patients with chronic heart failure and left ventricular ejection fraction ≥40% is poorly understood. The aim of our analysis was to evaluate the efficacy of a telemedicine-based intervention specifically in these patients, as compared to standard of care alone.Methods:
The Insuficiència Cardiaca Optimització Remota (iCOR) study was a single centre, randomised, controlled trial, designed to evaluate a telemedicine intervention added to an existing hospital/primary care multidisciplinary, integrated programme for chronic heart failure patients. 178 participants were randomised to telemedicine or usual care, and were followed for six months. For the present sub-analysis, only iCOR participants (n = 116) with left ventricular ejection fraction ≥40% were included. The primary study endpoint was the incidence of an acute non-fatal heart failure event, defined as a new episode of worsening of symptoms and signs consistent with acute heart failure requiring intravenous diuretic therapy. The healthcare-related costs in each study group were also evaluated.Results:
The incidence of the first occurrence of the primary endpoint was significantly lower in the telemedicine arm (22% vs 56%, p<0.001), with a hazard ratio of 0.33 comparing to the usual care arm (95% confidence interval 0.170.64). Telemedicine was also associated with lower mean overall chronic heart failure care-related costs compared to usual care (8163 vs 4993, p=0.001). The results were consistent in both left ventricular ejection fraction of 4049% and left ventricular ejection fraction ≥50% patients.Conclusions:
Our results suggest that telemedicine is a promising strategy for the management of chronic heart failure patients with left ventricular ejection fraction ≥40%. These findings should be replicated in larger cohorts.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Gastos em Saúde
/
Telemedicina
/
Insuficiência Cardíaca
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article