title: Evaluation of a telemedicine system for heart failure patients: feasibility, acceptance rate, satisfaction and changes in patient behavior: results from the CARME (CAtalan Remote Management Evaluation) study.
abstract: BACKGROUND
  Telemedicine can be useful for managing heart failure (HF), but patient acceptance of telemedicine and its impact on patient behavior are unclear.
  
  
  OBJECTIVE
  To assess a telemedicine program in a HF Unit.
  
  
  RESULTS
  This sub-analysis of the CARME study assessed the use of an interactive telemedicine platform. This prospective intervention study had a before/after design with HF patients randomized 1:1 into two groups: (A) Motiva system (educational videos, motivational messages, and questionnaires); and (B) Motiva system + telemonitoring of blood pressure, heart rate and weight. Of 211 patients screened, 44 were excluded, 62 did not consent to participate and 8 withdrew consent prior to installation of the system. The final study population included 97 patients. During 1 year of follow-up, 22 patients voluntarily discontinued use of the system, 5 died (three after early discontinuation) and 5 withdrew consent before the last evaluation. A total of 15,017 questionnaires were sent to patients, with a median response rate of 88%. Satisfaction with the system and tools was high (median score 8.4/10), especially with the self-monitoring chart, scale and sphygmomanometer. Positive changes were observed in patient behavior, especially for blood pressure and weight control (p < 0.001). After the study, 65% of the patients wished to continue with telemonitoring, particularly those in group B (p = 0.004).
  
  
  CONCLUSIONS
  Less than half of our patients participated in the telemedicine study. However, those who completed the study had confidence in the system, a high degree of satisfaction with the tools and positive behavioral changes.
authors.affiliation: Unitat d'Insuficiència Cardíaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
authors.forename: Mar
authors.initials: M
authors.lastname: Domingo
authors.forename: Josep
authors.initials: J
authors.lastname: Lupón
authors.forename: Beatriz
authors.initials: B
authors.lastname: González
authors.forename: Eva
authors.initials: E
authors.lastname: Crespo
authors.forename: Raúl
authors.initials: R
authors.lastname: López
authors.forename: Anna
authors.initials: A
authors.lastname: Ramos
authors.forename: Agustàn
authors.initials: A
authors.lastname: Urrutia
authors.forename: Guillem
authors.initials: G
authors.lastname: Pera
authors.forename: José Ma
authors.initials: JM
authors.lastname: Verdú
authors.forename: Antoni
authors.initials: A
authors.lastname: Bayes-Genis
mesh_terms: D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D015438:Health Behavior; D006333:Heart Failure / Q000175:diagnosis / Q000628:therapy*; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011446:Prospective Studies; D013030:Spain; D018709:Statistics, Nonparametric; D017216:Telemedicine / Q000706:statistics & numerical data*