title: Home-based telemanagement in chronic heart failure: an 8-year single-site experience.
abstract: During an eight-year period, 358 patients with chronic heart failure (CHF) were enrolled in a six-month home-based telemanagement (HBT) programme. The efficacy of the programme was evaluated in two four-year periods, based on changes in clinical, functional, Quality of Life (QoL) status and rate of hospital readmission. The New York Heart Association (NYHA) class and the number of patients with comorbidities increased significantly in the second period, while the number of patients with beta-blockers decreased significantly (P < 0.01). Following the HBT programme, non-cardiovascular hospital readmission rate and all-cause readmission rate increased by 11% (P < 0.03) and 13% (P < 0.05), respectively. On re-evaluation after six months (238 patients) there was a general improvement in clinical, functional and QoL status and a significant increase in the mean daily dosage of beta-blockers prescribed. Our experience confirms that HBT for patients with CHF is associated with favourable effects on hospital readmission for cardiovascular reasons and on QoL. However, a more comprehensive multidisciplinary approach will probably be required to obtain favourable effects on total morbidity.
authors: Cardiovascular Rehabilitation Department, Fondazione Salvatore Maugeri, IRCCS, Institute of Lumezzane, Via Giuseppe Mazzini 129, 25066 Lumezzane, Brescia, Italy. amerigo.giordano@fsm.it
authors: Amerigo
authors: A
authors: Giordano
authors: Emanuela
authors: E
authors: Zanelli
authors: Simonetta
authors: S
authors: Scalvini
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000517:prevention & control / Q000628:therapy*; D018575:Home Care Services, Hospital-Based / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000458:organization & administration*; D010359:Patient Readmission / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D015397:Program Evaluation; D011788:Quality of Life; D012720:Severity of Illness Index; D017216:Telemedicine / Q000458:organization & administration*
chemical_list: D000319:Adrenergic beta-Antagonists