Impact on clinical events and healthcare costs of adding telemedicine to multidisciplinary disease management programmes for heart failure: Results of a randomized controlled trial

Source: Comin-Colet et al. 2016 - Pubmed ID: 26350543

Setting: Spain, Hospital

Study design:

RCT

 

Follow up: 6 months

Patient group:

Sample size:

Total: 188 (178)

IG: 88 (81)

CG: 100 (97)

 

Inclusion criteria:

  • Heart failure
Type of technology:

Home monitoring

  • Weight, heart rate and blood pressure record
  • Data transmission

Webpage

  • Monitoring of vital signs
  • Monitoring of symptoms
  • Alarms
  • Treatment adjustment
  • Education
Intervention:

Intervention: Telemedicine multidisciplinary nurse-based hospital-primary care integrated disease management programme. Daily automated telemonitoring using the web platform. Virtual video contacts between the health care professional and the patient (caregiver). Telemedicine HF nurses reviewed alarms every day, adjusted the medicine or contacted cardiologist. Continuity of care was provided by the primary care team including a case manager, primary care doctor and nurse and the primary care cardiologist. Early home visit to set the system up

 

Duration: 6 months
Add on:  +

 

Control group: Usual care

Clinical effect/ Patient safety:

Clinical effect:

  • Non-fatal HF events↓
  • Mortality→
  • All-cause death or non-fatal HF event↓
  • All cause death of HF hospitalization↓

 

Patient safety: 

  • Non-fatal HF events↓
  • Mortality→
  • All-cause death or non-fatal HF event↓
  • All cause death of HF hospitalization↓
Patient experiences/ Staff experiences:

Patient experience: NA

 

Staff experience: NA

Costs and organization:

Investment:

Equipment/Materials

  • Telefonica Soluciones web platform
  • Tablet

 

Running:

Technical

  • Telefonica Soluciones webplatform
  • Tablet

Staff

  • Monitoring
  • Treatment adjustment
  • Technical assistance

 

Organization:

  • Collaboration between hospital and primary care

 

Health care utilization:

  • HF hospitalization↓
  • CV hospitalizaiton↓
  • Non CV hospitalization→
  • Hospitalization↓
  • Total hospitalizations costs↓
  • Costs of diagnostic procedures↓
  • Costs of ambulatory care↓
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Information

“↑”: Statistically significant increase

“↓”: Statistically significant decrease

“→”: Statistically insignificant (no difference)