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Impact of patient engagement in a French telemonitoring programme for heart failure on hospitalization and mortality
AIMS: Management of patients with recently decompensated heart failure by hospital services is expensive, complicated to plan, and not always effective. Telemedicine programmes in heart failure may improve the quality of care, but their effectiveness is poorly documented in real‐world settings. The...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9715861/ https://www.ncbi.nlm.nih.gov/pubmed/35715956 http://dx.doi.org/10.1002/ehf2.13978 |
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author | Sabatier, Rémi Legallois, Damien Jodar, Mouna Courouve, Laurène Donio, Valérie Boudevin, Florence De Chalus, Thibault Hauchard, Karine Belin, Annette Milliez, Paul |
author_facet | Sabatier, Rémi Legallois, Damien Jodar, Mouna Courouve, Laurène Donio, Valérie Boudevin, Florence De Chalus, Thibault Hauchard, Karine Belin, Annette Milliez, Paul |
author_sort | Sabatier, Rémi |
collection | PubMed |
description | AIMS: Management of patients with recently decompensated heart failure by hospital services is expensive, complicated to plan, and not always effective. Telemedicine programmes in heart failure may improve the quality of care, but their effectiveness is poorly documented in real‐world settings. The study aims to evaluate the impact of patient engagement in home‐based telemonitoring for heart failure (SCAD programme) on rehospitalization and mortality rates. METHODS AND RESULTS: A retrospective observational study was performed in 659 SCAD participants. SCAD is a patient‐oriented service of home‐based interactive telemonitoring offered to heart failure patients during hospitalization who agree to participate in a therapeutic education programme. Patients were telemonitored for at least 3 months, and rehospitalization and mortality were documented at 12 months and 5 years. During the telemonitoring period, patients provided daily information on health and lifestyle through an internet‐based interface. Data were linked on a patient‐by‐patient basis between the SCAD database and the French national health insurance database (Système National des Données de Santé). Outcomes were compared as a function of use of the programme. Low, intermediate, and high users were classified by tercile of data return during telemonitoring. Patients were followed for a median of 32.9 months. Rehospitalization rates for cardiovascular disease decreased from 79.4% in the year preceding enrolment to 41.1% in the following year and from 52.8% to 18.8% for hospitalizations for heart failure. The 12 month mortality rate was 11.2%. Significant associations were observed between level of use of the SCAD programme and all‐cause rehospitalization (P = 0.0085), rehospitalization for cardiovascular disease (P = 0.0010), rehospitalization for heart failure (27.8% in low users, 12.9% in intermediate users, and 13.5% in high users; P < 0.0001), and mortality (26.8%, 15.2%, and 15.9% respectively; P = 0.0157) in the 12 months following enrolment. The mean number of days alive outside hospital were 279 ± 111 in low users, 312 ± 90 in intermediate users, and 304 ± 100 in high users (P = 0.0022). CONCLUSIONS: Educational home telemonitoring of patients with heart failure following hospitalization provides long‐term clinical benefits in terms of rehospitalization and death in real‐world settings, according to the level of use of the programme by the patient. These benefits would be expected to have a major impact on the burden of this disease. Low engagement in telemonitoring could be used as a signal of poor prognosis and taken into account in the management strategy. |
format | Online Article Text |
id | pubmed-9715861 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97158612022-12-05 Impact of patient engagement in a French telemonitoring programme for heart failure on hospitalization and mortality Sabatier, Rémi Legallois, Damien Jodar, Mouna Courouve, Laurène Donio, Valérie Boudevin, Florence De Chalus, Thibault Hauchard, Karine Belin, Annette Milliez, Paul ESC Heart Fail Original Articles AIMS: Management of patients with recently decompensated heart failure by hospital services is expensive, complicated to plan, and not always effective. Telemedicine programmes in heart failure may improve the quality of care, but their effectiveness is poorly documented in real‐world settings. The study aims to evaluate the impact of patient engagement in home‐based telemonitoring for heart failure (SCAD programme) on rehospitalization and mortality rates. METHODS AND RESULTS: A retrospective observational study was performed in 659 SCAD participants. SCAD is a patient‐oriented service of home‐based interactive telemonitoring offered to heart failure patients during hospitalization who agree to participate in a therapeutic education programme. Patients were telemonitored for at least 3 months, and rehospitalization and mortality were documented at 12 months and 5 years. During the telemonitoring period, patients provided daily information on health and lifestyle through an internet‐based interface. Data were linked on a patient‐by‐patient basis between the SCAD database and the French national health insurance database (Système National des Données de Santé). Outcomes were compared as a function of use of the programme. Low, intermediate, and high users were classified by tercile of data return during telemonitoring. Patients were followed for a median of 32.9 months. Rehospitalization rates for cardiovascular disease decreased from 79.4% in the year preceding enrolment to 41.1% in the following year and from 52.8% to 18.8% for hospitalizations for heart failure. The 12 month mortality rate was 11.2%. Significant associations were observed between level of use of the SCAD programme and all‐cause rehospitalization (P = 0.0085), rehospitalization for cardiovascular disease (P = 0.0010), rehospitalization for heart failure (27.8% in low users, 12.9% in intermediate users, and 13.5% in high users; P < 0.0001), and mortality (26.8%, 15.2%, and 15.9% respectively; P = 0.0157) in the 12 months following enrolment. The mean number of days alive outside hospital were 279 ± 111 in low users, 312 ± 90 in intermediate users, and 304 ± 100 in high users (P = 0.0022). CONCLUSIONS: Educational home telemonitoring of patients with heart failure following hospitalization provides long‐term clinical benefits in terms of rehospitalization and death in real‐world settings, according to the level of use of the programme by the patient. These benefits would be expected to have a major impact on the burden of this disease. Low engagement in telemonitoring could be used as a signal of poor prognosis and taken into account in the management strategy. John Wiley and Sons Inc. 2022-06-17 /pmc/articles/PMC9715861/ /pubmed/35715956 http://dx.doi.org/10.1002/ehf2.13978 Text en © 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Sabatier, Rémi Legallois, Damien Jodar, Mouna Courouve, Laurène Donio, Valérie Boudevin, Florence De Chalus, Thibault Hauchard, Karine Belin, Annette Milliez, Paul Impact of patient engagement in a French telemonitoring programme for heart failure on hospitalization and mortality |
title | Impact of patient engagement in a French telemonitoring programme for heart failure on hospitalization and mortality |
title_full | Impact of patient engagement in a French telemonitoring programme for heart failure on hospitalization and mortality |
title_fullStr | Impact of patient engagement in a French telemonitoring programme for heart failure on hospitalization and mortality |
title_full_unstemmed | Impact of patient engagement in a French telemonitoring programme for heart failure on hospitalization and mortality |
title_short | Impact of patient engagement in a French telemonitoring programme for heart failure on hospitalization and mortality |
title_sort | impact of patient engagement in a french telemonitoring programme for heart failure on hospitalization and mortality |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9715861/ https://www.ncbi.nlm.nih.gov/pubmed/35715956 http://dx.doi.org/10.1002/ehf2.13978 |
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