Robert K. Riezebos, MD
Does telemonitoring reduce readmissions or mortality in patients recently hospitalized for heart failure?
Randomized controlled trial (Telemonitoring to Improve Heart Failure Outcomes [Tele-HF]). ClinicalTrials.gov NCT00303212.
Blinded (hospital readmission adjudicators).†
33 cardiology practices in the USA.
1653 patients (median age 61 y, 58% men) who were hospitalized for heart failure in the past 30 days. Exclusion criteria included long-term nursing home residence, life expectancy ≤ 6 months due to conditions other than heart failure, severe cognitive impairment, and planned hospitalization for a procedure.
Telemonitoring, using the Tel-Assurance (Pharos Innovations) system (n = 826), or usual care (n = 827). After training, patients in the telemonitoring group called the system daily and used the keypad to answer questions about general health and heart-failure symptoms. Site coordinators reviewed downloaded data each weekday, followed up with patients whose responses had been automatically flagged for clinician attention, and documented management decisions.
Primary endpoint was a composite of hospital readmission for any reason or all-cause mortality. Other outcomes included hospitalization for heart failure. The study had 80% power to detect a 15% relative reduction in the primary endpoint from 50% (α = 0.05).
100% for readmissions and vital status (intention-to-treat analysis).
Telemonitoring did not reduce hospital readmissions or deaths more than usual care overall (Table) or in any prespecified patient subgroup (age, sex, race, left ventricular ejection fraction, or New York Heart Association class).
Telemonitoring did not reduce readmissions or mortality more than usual care in patients recently hospitalized for heart failure.
Telemonitoring (TM) vs usual care (UC) in patients recently hospitalized for heart failure‡
‡Abbreviations defined in Glossary. RRI, RRR, and CI calculated from data in article.
§Hospital readmission for any reason or all-cause mortality.
Riezebos RK. Telemonitoring did not reduce readmissions or mortality in patients recently hospitalized for heart failure. Ann Intern Med. 2011;154:JC3–8. doi: 10.7326/0003-4819-154-6-201103150-02008
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Published: Ann Intern Med. 2011;154(6):JC3-8.
Cardiology, Heart Failure, Hospital Medicine.
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