title: Effect of a telemonitoring-facilitated collaboration between general practitioner and heart failure clinic on mortality and rehospitalization rates in severe heart failure: the TEMA-HF 1 (TElemonitoring in the MAnagement of Heart Failure) study.
abstract: OBJECTIVE
  Chronic heart failure (CHF) patients are frequently rehospitalized within 6 months after an episode of fluid retention. Rehospitalizations are preventable, but this requires an extensive organization of the healthcare system. In this study, we tested whether intensive follow-up of patients through a telemonitoring-facilitated collaboration between general practitioners (GPs) and a heart failure clinic could reduce mortality and rehospitalization rate.
  
  
  RESULTS
  One hunderd and sixty CHF patients [mean age 76 ± 10 years, 104 males, mean left ventricular ejection fraction (LVEF) 35 ± 15%] were block randomized by sealed envelopes and assigned to 6 months of intense follow-up facilitated by telemonitoring (TM) or usual care (UC). The TM group measured body weight, blood pressure, and heart rate on a daily basis with electronic devices that transferred the data automatically to an online database. Email alerts were sent to the GP and heart failure clinic to intervene when pre-defined limits were exceeded. All-cause mortality was significantly lower in the TM group as compared with the UC group (5% vs. 17.5%, P = 0.01). The total number of follow-up days lost to hospitalization, dialysis, or death was significantly lower in the TM group as compared with the UC group (13 vs. 30 days, P = 0.02). The number of hospitalizations for heart failure per patient showed a trend (0.24 vs. 0.42 hospitalizations/patient, P = 0.06) in favour of TM.
  
  
  CONCLUSIONS
  Telemonitoring-facilitated collaboration between GPs and a heart failure clinic reduces mortality and number of days lost to hospitalization, death, or dialysis in CHF patients. These findings need confirmation in a large trial.
authors: Hasselt University, Faculty of Medicine, Diepenbeek, Belgium. paul.dendale@uhasselt.be
authors: Paul
authors: P
authors: Dendale
authors: Gilles
authors: G
authors: De Keulenaer
authors: Pierre
authors: P
authors: Troisfontaines
authors: Caroline
authors: C
authors: Weytjens
authors: Wilfried
authors: W
authors: Mullens
authors: Ivan
authors: I
authors: Elegeert
authors: Bavo
authors: B
authors: Ector
authors: Marita
authors: M
authors: Houbrechts
authors: Koen
authors: K
authors: Willekens
authors: Dominique
authors: D
authors: Hansen
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002300:Cardiac Care Facilities / Q000706:statistics & numerical data*; D003299:Cooperative Behavior; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data*; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D012307:Risk Factors; D012720:Severity of Illness Index; D013318:Stroke Volume; D017216:Telemedicine / Q000295:instrumentation* / Q000379:methods; D017211:Treatment Failure; D016277:Ventricular Function, Left
chemical_list: D000959:Antihypertensive Agents