title: [Disease management for heart failure patients: role of wireless technologies for telemedicine. The ICAROS project].
abstract: Healthcare costs for heart failure are increasing. The need for a better care, however, has to be matched with a policy of cost containment. A way to improve the cost-effectiveness of heart failure care is the disease management approach, in which therapy, education and follow-up are tailored for each patient by a multidisciplinary team. Such a complex intervention can be facilitated by the use of telemedicine, which allows the remote control of considerable amounts of clinical data. In Italy, a few studies with telemedicine have been reported. A recent development in this field is represented by the ICAROS project (Integrated Care vs Conventional Intervention in Cardiac Failure Patients: Randomized Open Label Study), whose aim is to improve the clinical and psychological care of heart failure patients employing advanced wireless telecommunication technology. So far, we randomized 60 patients: 30 in usual ambulatory care, 30 in an intensive treatment group. The latter patients were instructed to use a portable computer to get in touch daily with the heart failure clinic and receive feedback instruction for the management of drug therapy and daily problems. At the first year of follow-up, the treatment group showed good compliance to drug prescriptions, and could easily handle the portable computer. The preliminary results of this ongoing study support the feasibility and appropriateness of new technologies for the management of heart failure, even in elderly patients in whom a limited expertise with these appliances could have been anticipated.
authors.affiliation: Cardiologia, Ospedale San Luca, Istituto Auxologico Italiano IRCCS, Milano.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Villani
authors.forename: Gabriella
authors.initials: G
authors.lastname: Malfatto
authors.forename: Francesco
authors.initials: F
authors.lastname: Della Rosa
authors.forename: Giovanna
authors.initials: G
authors.lastname: Branzi
authors.forename: Simona
authors.initials: S
authors.lastname: Boarin
authors.forename: Claudio
authors.initials: C
authors.lastname: Borghi
authors.forename: Eugenio
authors.initials: E
authors.lastname: Cosentino
authors.forename: Massimo
authors.initials: M
authors.lastname: Gualerzi
authors.forename: Paolo
authors.initials: P
authors.lastname: Coruzzi
authors.forename: Enrico
authors.initials: E
authors.lastname: Molinari
authors.forename: Angelo
authors.initials: A
authors.lastname: Compare
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cassi
authors.forename: Stefano
authors.initials: S
authors.lastname: Collatina
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Parati
mesh_terms: D000368:Aged; D000553:Ambulatory Care; D034201:Computers, Handheld / Q000706:statistics & numerical data; D003422:Critical Care; D019468:Disease Management; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000523:psychology / Q000628:therapy*; D006699:Home Care Services; D006801:Humans; D007558:Italy; D008297:Male; D008838:Microcomputers / Q000706:statistics & numerical data; D008875:Middle Aged; D010349:Patient Compliance; D011795:Surveys and Questionnaires; D017216:Telemedicine; D013997:Time Factors