[Will telemonitoring be adopted by patients with chronic heart failure?].
BACKGROUND
Remote Patient Management for chronic heart failure (CHF) is gaining increasing importance in health care. Telemonitoring is defined as daily measuring of health parameters by the patient and their transmission to a telemedical centre. The adherence of this action by the patient can be considered as a measure for RPM adoption.


METHODS
The randomized controlled clinical trial TIM-HF (NCT 00543881) was conducted between 2008 and 2010 with 710 CHF patients with the primary endpoint total mortality for a mean follow-up of 21.5 ± 7.2 months. The non-prespecified analysis of adherence to daily measuring of ECG, blood pressure, weight and self-assessment was focused on sociodemographic and disease-related factors of the 354 RPM patients.


RESULTS
The mean adherence to telemonitoring was more than 80% (absolute adherence: 81.8 ± 22.8%, relative adherence: 88.9 ± 21.5%). From the beginning of treatment 6.5% of the patients (23/354) have shown an adherence below average. The high adherence of the majority of the patients was stable for the entire study duration and irrespective of age, sex, severity of the disease and the presence of mild to moderate depression.


CONCLUSIONS
A high adherence can be achieved by individual training of the patient regarding the handling of his disease, the use of telemedical devices and an easy-to-use telemonitoring system. The majority of the informed self-determined CHF patients NYHA class II/III are adopting telemonitoring and are adherent in the long term.
Charité-Universitätsmedizin Berlin, Med. Klinik m.S. Kardiologie und Angiologie, Zentrum für kardiovaskuläre Telemedizin, Berlin.
S
S
Prescher
Charité-Universitätsmedizin Berlin, Med. Klinik m.S. Kardiologie und Angiologie, Zentrum für kardiovaskuläre Telemedizin, Berlin.
O
O
Deckwart
Charité-Universitätsmedizin Berlin, Med. Klinik m.S. Kardiologie und Angiologie, Zentrum für kardiovaskuläre Telemedizin, Berlin.
K
K
Koehler
Charité-Universitätsmedizin Berlin, Med. Klinik m.S. Kardiologie und Angiologie, Zentrum für kardiovaskuläre Telemedizin, Berlin.
S
S
Lücke
Kardiologische Gemeinschaftspraxis Stuttgart-Feuerbach, Stuttgart.
M
M
Schieber
Charité-Universitätsmedizin Berlin, Med. Klinik m.S. Kardiologie und Angiologie, Zentrum für kardiovaskuläre Telemedizin, Berlin.
B
B
Wellge
Unfallkrankenhaus Berlin, Klinik für Innere Medizin/ Kardiologie, Berlin.
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S
Winkler
Charité-Universitätsmedizin Berlin, Med. Klinik m.S. Kardiologie und Angiologie, Zentrum für kardiovaskuläre Telemedizin, Berlin.
G
G
Baumann
Charité-Universitätsmedizin Berlin, Med. Klinik m.S. Kardiologie und Angiologie, Zentrum für kardiovaskuläre Telemedizin, Berlin.
F
F
Koehler
D000368:Aged; D018660:Blood Pressure Monitoring, Ambulatory / Q000523:psychology; D001835:Body Weight; D004562:Electrocardiography; D005260:Female; D005858:Germany; D006333:Heart Failure / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D010352:Patient Dropouts / Q000706:statistics & numerical data; D019114:Remote Consultation / Q000706:statistics & numerical data*; D013686:Telemetry / Q000523:psychology / Q000706:statistics & numerical data*; D014600:Utilization Review / Q000706:statistics & numerical data