title: Efficacy of a Physician-Led Multiparametric Telemonitoring System in Very Old Adults with Heart Failure.
abstract: OBJECTIVE
  To evaluate the effect of an innovative model integrating telemonitoring of vital parameters and telephone support on 6-month survival and hospital admissions of elderly adults with heart failure (HF).
  
  
  METHODS
  Parallel-arm, randomized trial.
  
  
  METHODS
  Geriatric acute care ward and outpatient clinic at Policlinico Campus Biomedico (Rome, Italy).
  
  
  METHODS
  Individuals with HF aged 65 and older (mean age 80) randomly assigned to intervention (n = 50) or control (n = 46). Participants had an average ejection fraction of 46%.
  
  
  METHODS
  Telemonitoring system (receives and communicates oxygen saturation, heart rate, and blood pressure readings) and office-hours telephonic support provided by a geriatrician.
  
  
  METHODS
  Combination of all-cause death and hospital admissions.
  
  
  RESULTS
  The two groups were similar with the exception of the prevalence of women and of disability (both more common in the control group). Three patients for each group were lost to follow-up (final analyzed sample size: 90). Incidence of the main outcome was 42% in the control group and 21% in the intervention group (relative risk = 0.51, 95% confidence interval (CI) = 0.26-0.98). The results were unchanged after taking into account the setting of enrollment, sex, and disability (hazard ratio = 0.42, 95% CI = 0.19-0.94).
  
  
  CONCLUSIONS
  Telemonitoring of elderly people with HF is feasible and reduces the risk of death and hospitalization. Further studies are needed to confirm these findings and evaluate the cost-efficacy of the service.
authors.affiliation: Area di Geriatria, Università Campus Bio-Medico di Roma, Rome, Italy.|Fondazione Alberto Sordi, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Pedone
authors.affiliation: Area di Geriatria, Università Campus Bio-Medico di Roma, Rome, Italy.
authors.forename: Francesca Flavia
authors.initials: FF
authors.lastname: Rossi
authors.affiliation: Area di Geriatria, Università Campus Bio-Medico di Roma, Rome, Italy.
authors.forename: Annagrazia
authors.initials: A
authors.lastname: Cecere
authors.affiliation: Area di Geriatria, Università Campus Bio-Medico di Roma, Rome, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Costanzo
authors.affiliation: Area di Geriatria, Università Campus Bio-Medico di Roma, Rome, Italy.|Fondazione San Raffaele, Cittadella della Carità, Taranto, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Antonelli Incalzi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020000:Decision Support Systems, Clinical; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006333:Heart Failure / Q000451:nursing*; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D011369:Professional-Patient Relations; D015397:Program Evaluation; D012648:Self Care / Q000379:methods; D017216:Telemedicine / Q000379:methods*
keywords: aged; heart failure; long-term care; prevention; telemedicine