title: Potential role for clinical calibration to increase engagement with and application of home telemonitoring: a report from the HeartCycle programme.
abstract: OBJECTIVE
  There is a need for alternative strategies that might avoid recurrent admissions in patients with heart failure. home telemonitoring (HTM) to monitor patient's symptoms from a distance may be useful. This study attempts to assess changes in HTM vital signs in response to daily life activities (variations in medication, salt intake, exercise, and stress) and to establish which variations affect weight, blood pressure, and heart rate.
  
  
  RESULTS
  We assessed 76 patients with heart failure (mean age 76 ± 10.8 years, 75% male, mainly in NYHA class II/III and from ischaemic aetiology cause). Patients were given a calendar of interventions scheduling activities approximately twice a week before measuring their vital signs. Eating salty food or a large meal were the activities that had a significant impact on weight gain (+0.3 kg;P< 0.001 andP= 0.006, respectively). Exercise and skipping a dose of medication other than diuretics increased heart rate (+3 bpm,P= 0.001 and almost +2 bpm,P= 0.016, respectively).
  
  
  CONCLUSIONS
  Our HTM system was able to detect small changes in vital signs related to these activities. Further studies should assess if providing such a schedule of activities might be useful for patient education and could improve long-term adherence to recommended lifestyle changes.
authors.affiliation: ICREC Research Program Fundació Institut d´Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP) Badalona Spain.
authors.forename: Paloma
authors.initials: P
authors.lastname: Gastelurrutia
authors.affiliation: Cardiology ServiceHospital Universitari Germans Trias i PujolBadalonaSpain; Department of MedicineUniversitat Autònoma de BarcelonaBarcelonaSpain.
authors.forename: Josep
authors.initials: J
authors.lastname: Lupón
authors.affiliation: Cardiology Service Hospital Universitari Germans Trias i Pujol Badalona Spain.
authors.forename: Mar
authors.initials: M
authors.lastname: Domingo
authors.affiliation: Philips Research Eindhoven The Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: Stut
authors.affiliation: Philips Research Eindhoven The Netherlands.
authors.forename: Silviu
authors.initials: S
authors.lastname: Dovancescu
authors.affiliation: National Heart and Lung Institute Harefield Hospital, Imperial College London UK.
authors.forename: John
authors.initials: J
authors.lastname: Cleland
authors.affiliation: Heidelberg University Hospital Heidelberg Germany.
authors.forename: Lutz
authors.initials: L
authors.lastname: Frankenstein
authors.affiliation: ICREC Research ProgramFundació Institut d´Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP)BadalonaSpain; Cardiology ServiceHospital Universitari Germans Trias i PujolBadalonaSpain; Department of MedicineUniversitat Autònoma de BarcelonaBarcelonaSpain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Bayes-Genis
keywords: Heart failure; Self‐management; Telemonitoring