title: [Noninvasive remote telemonitoring for ambulatory patients with heart failure: effect on number of hospitalizations, days in hospital, and quality of life. CARME (CAtalan Remote Management Evaluation) study].
abstract: OBJECTIVE
  Multidisciplinary strategies for the management of heart failure (HF) improve outcomes. We aimed to evaluate the effectiveness of noninvasive home telemonitoring in ambulatory patients with HF already included in a structured multidisciplinary HF program.
  
  
  METHODS
  Prospective intervention study with before/after comparison design of an interactive telemedicine platform in HF patients, randomized 1:1 into two groups: A) Motiva System with educational videos, motivational messages, and questionnaires, and B) Motiva System + self monitoring of blood pressure, heart rate, and weight. Hospitalizations were compared over 12 months prior to and post study inclusion. Quality of life was evaluated using the generic EuroQoL visual analogue scale and the specific questionnaire Minnesota Living With Heart Failure Questionnaire.
  
  
  RESULTS
  There were 92 patients included (71% male; 66.3 ± 11.5 years; 71% ischemic aetiology). During real-time telemonitoring over 11.8 months (interquartile range 8.6-12), 14,730 questionnaires were administered with 89% median response rate. Hospitalizations for HF decreased by 67.8% (P = .010) and for other cardiac causes by 57.6% (P = .028). The number of days in hospital for HF decreased by 73.3% (P =.036), without statistically significant differences between groups, and for other cardiac causes by 82.9% (P =.008). The perception of quality of life improved significantly both for the generic scale (P < .001) and for the HF specific questionnaire (P=.005).
  
  
  CONCLUSIONS
  HF patients who used an interactive telehealth system with motivational support tools at home spent less time in hospital and felt their quality of life had significantly improved. No significant differences were observed between groups.
authors.affiliation: Unitat d'Insuficiència Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
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: Agustín
authors.initials: A
authors.lastname: Urrutia
authors.forename: Guillem
authors.initials: G
authors.lastname: Pera
authors.forename: José M
authors.initials: JM
authors.lastname: Verdú
authors.forename: Antoni
authors.initials: A
authors.lastname: Bayes-Genis
mesh_terms: D000368:Aged; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000379:methods*; D017202:Myocardial Ischemia / Q000150:complications; D010045:Outpatients; D010359:Patient Readmission / Q000706:statistics & numerical data; D011446:Prospective Studies; D011788:Quality of Life; D017216:Telemedicine / Q000379:methods*; D013686:Telemetry