Telemedical monitoring and coaching improves survival and hospitalisation rates in heart failure

Abstract

Abstract Aims To investigate the effectiveness of a combined telemonitoring and telecoaching programme for chronic heart failure patients at high risk for hospitalisation compared to usual care in a real life setting. The applied telehealth programme consisted of regular individualised telecoaching sessions as well as daily remote telemonitoring of heart failure signs and symptoms. Methods Between January 2018 and September 2020, 6,065 heart failure patients were enrolled in a combined telehealth programme and retrospectively compared to a propensity matched usual care group (n=6,065). All participants were members of a statutory health insurance. Median follow-up was 442 days (IQR 309–681). Endpoints were all cause mortality, number and duration of hospitalisations. Results After 1 year the combined telecoaching and telemonitoring programme significantly reduced all-cause mortality probability compared to usual care (11.0 vs. 5.8%, p<0.001). The corresponding number-needed to treat to prevent one death in one year was 19.3. In addition, the number of hospitalisations for heart failure (17.9 vs. 21.8 per 100 patient years, p<0.001) and all cause hospitalisations (129.0 vs. 133.2, p=0.015), as well as their duration (2.0 vs. 2.6 days per year p<0.001, and 12.0 vs. 13.4 days per year p>0.001, respectivel y) were significantly lower in the telehealth group than in the usual care group. Conclusion In ambulatory heart failure patients at high risk for hospitalisation, a combined telemonitoring and telecoaching programme led to a reduction of heart failure hospitalisations and all-cause mortality compared to standard care. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): Health Care Systems GmbH (HCSG), Pullach i. Isartal