title: Telemedical support in patients with chronic heart failure: experience from different projects in Germany.
abstract: The great epidemiological significance and costs associated with chronic heart failure pose a challenge to health systems in Western industrial countries. In the past few years, controlled randomised studies have shown that patients with chronic heart failure benefit from telemedical monitoring; specifically, telemonitoring of various vital parameters combined with a review of the symptoms, drug compliance and patient education. In Germany, various telemedical monitoring projects for patients with chronic heart failure have been initiated in the past few years; seven of them are presented here. Currently 7220 patients are being monitored in the seven selected projects. Most patients (51.1%) are in NYHA stage II, 26.3% in NYHA stage III, 14.5% in NYHA stage I and only 6.6% in NYHA stage IV respectively. Most projects are primarily regional. Their structure of telemedical monitoring tends to be modular and uses stratification according to the NYHA stages. All projects include medical or health economics assessments. The future of telemedical monitoring projects for patients with chronic heart failure will depend on the outcome of these assessments. Only of there is statistical evidence for medical benefit to the individual patient as well as cost savings will these projects continue.
authors.affiliation: Clinic of Internal Medicine, Chemnitz Hospital, Bürgerstrasse 2, 09113 Chemnitz, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Müller
authors.forename: Johannes
authors.initials: J
authors.lastname: Schweizer
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Helms
authors.forename: Micheal
authors.initials: M
authors.lastname: Oeff
authors.forename: Claudia
authors.initials: C
authors.lastname: Sprenger
authors.forename: Christian
authors.initials: C
authors.lastname: Zugck
references.citation: Circulation. 2006 Feb 14;113(6):799-805
references.pmid: 16461823
references.citation: Dtsch Med Wochenschr. 2007 Mar 2;132(9):417-22
references.pmid: 17315117
references.citation: Am Heart J. 2003 Oct;146(4):705-12
references.pmid: 14564327
references.citation: Heart. 2005 Jul;91(7):899-906
references.pmid: 15958358
references.citation: Am J Cardiol. 2001 Aug 15;88(4):382-7
references.pmid: 11545758
references.citation: Eur J Heart Fail. 2009 Mar;11(3):319-25
references.pmid: 19174529
references.citation: Dtsch Med Wochenschr. 2007 Mar 2;132(9):458-60
references.pmid: 17315125
references.citation: Circulation. 2005 Jan 18;111(2):179-85
references.pmid: 15642765
references.citation: Dtsch Arztebl Int. 2009 Apr;106(16):269-75
references.pmid: 19547628
references.citation: Eur J Heart Fail. 2005 Dec;7(7):1133-44
references.pmid: 16198629
references.citation: Eur Heart J. 2008 Oct;29(19):2388-442
references.pmid: 18799522
references.citation: Eur J Heart Fail. 2008 Dec;10(12):1236-45
references.pmid: 18996739
references.citation: Lancet. 2002 Nov 23;360(9346):1631-9
references.pmid: 12457785
references.citation: Herzschrittmacherther Elektrophysiol. 2005 Sep;16(3):150-8
references.pmid: 16177941
references.citation: Eur Heart J. 2009 Jul;30(13):1666-73
references.pmid: 19411662
references.citation: Eur J Heart Fail. 2005 Mar 16;7(3):423-8
references.pmid: 15718184
references.citation: Circulation. 1991 Jul;84(1):40-8
references.pmid: 2060110
references.citation: Am Heart J. 2005 Apr;149(4):722-9
references.pmid: 15990759
references.citation: Z Kardiol. 2005 Aug;94(8):488-509
references.pmid: 16049651
references.citation: Eur J Heart Fail. 2003 Oct;5(5):583-90
references.pmid: 14607195
references.citation: J Am Coll Cardiol. 2005 May 17;45(10):1654-64
references.pmid: 15893183
references.citation: Clin Res Cardiol. 2006 Jan;95 Suppl 2:II37-40
references.pmid: 16598571
references.citation: Herz. 2007 Dec;32(8):623-9
references.pmid: 18060608
references.citation: BMJ. 2007 May 5;334(7600):942
references.pmid: 17426062
references.citation: Eur J Heart Fail. 2001 Jun;3(3):315-22
references.pmid: 11378002
references.citation: Int J Cardiol. 2004 Oct;97(1):49-55
references.pmid: 15336806
references.citation: J Am Coll Cardiol. 1995 Nov 15;26(6):1417-23
references.pmid: 7594064
references.citation: Eur Heart J. 2006 Feb;27(4):434-40
references.pmid: 16230302
references.citation: Eur J Heart Fail. 2009 Mar;11(3):312-8
references.pmid: 19228800