Autonomous Province Of Trento Research Articles

Unpacking Perceptions on Patient Safety: A Study of Nursing Home Staff in Italy.

Nursing homes (NHs) are crucial for de-hospitalization and addressing the needs of non-self-sufficient individuals with complex health issues. This study investigates the patient safety culture (PSC) in NHs within a northern Italian region, focusing on factor influencing overall safety perceptions and their contributions to subjective judgements of safety. A cross-sectional study was conducted on 25 NHs in the Autonomous Province of Trento. The Nursing Home Survey on Patient Safety Culture (NHSPSC) was utilized to assess PSC among NH staff. Multilevel linear regression and post hoc dominance analyses were conducted to investigate variabilities in PSC among staff and NHs and to assess the extent to which PSC dimensions explain overall perceptions of PS. Analysis of 1080 questionnaires (44% response rate) revealed heterogeneity in PSC across dimensions and NHs, with management support, organizational learning, and supervisor expectations significantly influencing overall safety perceptions. Despite some areas of concern, overall safety perceptions were satisfactory. However, the correlation between individual dimensions and overall ratings of safety was moderate, suggesting the need to enhance the maturity level of PSCs. Promoting a shift in PSC could enhance transparency, prioritize resident safety, empower nursing staff, and increase family satisfaction with care provided in NHs. The support provided by management to PSC appears essential to influence NH staff perceptions of PS.

Valorizzare il territorio nella prospettiva del bene comune: l’esperienza trentina

The article explores the holistic and circular approach adopted in the Trentino region to promote human ecology, enhance the territory, and ensure children’s well-being. The participatory model, grounded in empathy and sustainability, advocates for the valorization of the territory. Introduced actions foster children’s emotional connection with the region and encourage collective responsibility. The Autonomous Province of Trento and the social cooperative Città Futura, by committing to sustainable development and supporting local small businesses, contribute to the formation of resilient communities focused on collective well-being, reflecting a profound commitment to human ecology and territorial enhancement.

Incidence, healthcare resource utilization and costs of hospitalized patients with tick-borne encephalitis (TBE) in Italy

ObjectiveOur study's objective was to assess the incidence trends and healthcare resource utilization of hospitalizations for Tick-Borne Encephalitis (TBE) and associated costs in Italy in order to improve public awareness and preventive measures. MethodsThis retrospective observational study was based on the Italian Ministry of Health's Hospital Discharge Record (HDR) database. Data were gathered across Italy from 2015 to 2019, selecting hospitalizations with ICD-9 code 063 related to TBE, both in primary and secondary diagnoses. For each year, we collected the following variables: number of hospitalizations, hospitalization rate, mortality rate, mean length of hospital stay, hospital ward, and cost of hospitalization. ResultsThere were a total of 237 hospitalizations from 2015 to 2019; 62 % of those were male. The lowest number of TBE hospitalizations was in 2015 (21 cases, corresponding to 0.35 per million inhabitants), the highest in 2019 (64 cases, 1.04 per million inhabitants). The summer months saw a greater than average number of hospitalizations. For the years analyzed, the cumulative number of cases peaked in June (54 cases), July (46 cases), and August (35 cases). There were only two deaths registered in our study sample. TBE cases were mostly localized in the North-Eastern regions of Italy. TBE incidence during the study period in the most affected areas were: Autonomous Province of Trento, ranging from 11.2 to 42.3 per million inhabitants, Autonomous Province of South Tyrol, from 0 to 21.1 per million inhabitants, and Veneto Region, from 2.6 to 4.5 per million inhabitants. In the study period, the average length of hospital stay was largely stable ranging from 10.6 days to 12.8 days, with related costs ranging from 5,813.7 € to 7,352.5 €. ConclusionsAccording to our data, the majority of TBE hospitalizations occur in North-East Italy with an increasing trend over the analyzed period. Even though Italy has fewer TBE cases than other neighboring European countries, the health and economic impact can be high in the affected areas.

Monitoring and tracking changes in sensitivity to zoxamide fungicide in Plasmopara viticola in Italy

Plasmopara viticola is controlled by fungicides with different modes of action, which include zoxamide. Zoxamide was developed in 1998 by Dow AgroSciences LIC (Indianapolis, IN) and has been commercialized since 2001 by Rohm and Haas Company. This fungicide is highly effective against oomycetes, used for foliar application in vine crops, potato, and other vegetables to control oomycete-induced diseases. Zoxamide acts by causing mitotic arrest by binding to β-tubulin, inhibiting tubulin polymerization and cell division of the pathogen. In the past three decades, the management of fungicide resistance has emerged as a significant concern for both growers and regulatory authorities; this is primarily due to the substantial increase in resistance, in terms of occurrence and spread, towards most fungicide groups. The monitoring of the effectiveness of fungicides is the only way to accurately identify as soon as possible the onset of resistance. In this study, we were interested in tracking the changes in the sensitivity of zoxamide to P. viticola populations collected during a 6-year monitoring (2017–2022) in two Italian locations: the autonomous province of Trento and the autonomous region of Friuli-Venezia Giulia. Bioassays on leaf discs were carried out, and EC50 and MIC values were elaborated. From our results, zoxamide showed for a long period of time high sensitivity, but over the last years we observed a change, as in 2022 most of the samples tested in these two regions showed MIC > 100 mg L−1.

A Multi-Approach and Collaborative Pathway towards Designing Climate Strategies: The Case of Trentino, a Mountainous Region in Italy

Mountainous and rural territories are considered among the most vulnerable to the effects of the Climate Crisis. Their geographical and topographical conditions, together with the complexity of the system of relations between human and natural elements, amplify the impacts and risks associated with extreme climatic events. Therefore, the consequences on the socio-economic fabric are systemic and require an immediate response from all the actors in a region. Public administration and politics can play a pivotal role within the planning framework in contrasting the impacts of the climate crisis. This paper demonstrates the multi-level and multi-stakeholder approach applied during the development process of a regional adaptation strategy. The Autonomous Province of Trento has initiated an innovative approach to understanding and managing the effects of the climate crisis on its landscape and resources and has aligned the process of definition of its long-term strategy with the guidance provided by the EU Commission and the Italian Government. The methodology used is based on the tools provided by the Climate-ADAPT platform (in particular, the Regional Adaptation Support Tool—RAST), and the “impact chains” method is specifically implemented for climate risk assessment. The RAST is applied according to a multi-stakeholder and multi-level approach to capitalise on previously established and ongoing initiatives and working groups. The research suggests that the Climate Strategy model presented in this paper needs to be at the core of the broader framework adopted by the Autonomous Province of Trento and that it can represent an important example for other regions aiming to actively involve local stakeholders in acting for climate neutrality and resilience.

HIV screening of migrants in the autonomous Province of Trento (North-Eastern Italy).

Migrants have accounted for more than 40% of new HIV diagnoses in Europe in 2022. Among the population of asylum seekers currently present in the Trento Province, screening for HIV infection is poorly carried out for various reasons. Here we report our experience about screening for HIV infection in asylum seekers present in that area using rapid self HIV-testing.

Overview on the Biosecurity Measures of Salmonid Fish Farms: A Case Study in Italy

Italy is one of the main European producers of trout fish, and the most important producing area is the Autonomous Province of Trento (APT) in the North East. The objective of the study was to obtain a snapshot of the trout farms of the APT by identifying biosecurity factors, objectifying them, and classifying the establishments accordingly. Data from 62 salmonid farms were collected using a national checklist in which biosecurity elements were identified and assessed using the method of expert elicitation. The purpose was to evaluate the levels of biosecurity of a trout farm in order to rank the risk of introduction and spread of infectious fish diseases. The main critical factors identified during this study were as following: (i) cleaning and disinfection of the cargo truck; (ii) regular collection, storage, and disposal of dead fish; (iii) presence of anti-bird nets; (iv) use of dedicated equipment for the different sectors of the farm; and (v) presence of external areas dedicated to the loading of dead fish.

Regional and sex inequalities of avoidable mortality in Italy: A time trend analysis

ObjectivesThis study provides a comprehensive analysis of avoidable mortality (AM), treatable mortality (TM), and preventable mortality (PM) across Italy, focusing on region- and gender-specific inequalities over a 14-year period. Study designTime-trend analysis (2006–2019). MethodsThe study was conducted using mortality data from the Italian Institute of Statistics to evaluate the extent and patterns of AM, TM, and PM in Italy. Biennial age-standardized mortality rates were calculated by gender and region using the joint OECD/Eurostat list. ResultsThe overall AM rates showed a large reduction from 2006/7 (221.0 per 100,000) to 2018/9 (166.4 per 100,000). Notably, females consistently displayed lower AM rates than males. Furthermore, both gender differences and the North–South gap of AM decreased during the period studied. The regions with the highest AM rates fluctuated throughout the study period. The highest percentage decrease in AM from 2006/7 to 2018/9, for both males (−41.3 %) and females (−34.2 %), was registered in the autonomous province of Trento, while the lowest reduction was observed in Molise for males (−17.4 %) and in Marche for females (−10.0 %). ConclusionsRemarkable gender and regional differences in AM between 2006 and 2019 have been recorded in Italy, although they have decreased over years. Continuous monitoring of AM and the implementation of region- and gender-specific interventions is essential to provide valuable insights for both policy and public health practice. This study contributes to the efforts to improve health equity between Italian regions.

Organisational models supported by technology for the management of diabetic disease and its complications in a diabetic clinic setting: study protocol for a randomised controlled trial targeting type 2 diabetes individuals with non-ideal glycaemic values (Telemechron study)

IntroductionType 2 diabetes mellitus (T2DM) is a non-communicable disease representing one of the most serious public health challenges of the twenty-first century. Its incidence continues to rise in both developed and developing countries, causing the death of 1.5 million people every year. The use of technology (e.g. smartphone application—App) in the health field has progressively increased as it has been proved to be effective in helping individuals manage their long-term diseases. Therefore, it has the potential to reduce the use of health service and its related costs. The objective of this study is to evaluate the impact of using a digital platform called “TreC Diabete” embedded into a novel organisational asset targeting poorly controlled T2DM individuals in the Autonomous Province of Trento (PAT), Italy.MethodsThis trial was designed as a multi-centre, open-label, randomised, superiority study with two parallel groups and a 1:1 allocation ratio. Individuals regularly attending outpatient diabetes clinics, providing informed consent, are randomised to be prescribed TreC Diabete platform as part of their personalised care plan. Healthcare staff members will remotely assess the data shared by the participants through the App by using a dedicated online medical dashboard. The primary end-point is the evaluation of the Hb1Ac level at 12-month post-randomisation. Data will be analysed on an intention-to-treat (ITT) basis.DiscussionThis trial is the first conducted in the PAT area for the use of an App specifically designed for individuals with poorly controlled T2DM. If the effects of introducing this specific App within a new organisational asset are positive, the digital platform will represent a possible way for people diagnosed with T2DM to better manage their health in the future. Results will be disseminated through conferences and peer-reviewed journals once the study is completed.Trial registrationClinicalTrials.gov NCT05629221. Registered on November 29, 2022, prior start of inclusion.

Patient Safety Subcultures among Nursing Home Staff in Italy: A Cross-Sectional Study

Nursing home (NH) residents are vulnerable subjects and highly susceptible to adverse events. Knowledge of patient safety culture (PSC) is essential for an organization to ensure patient safety. However, research on PSC in NHs, and its variability among staff, is still scarce. This study aimed to explore whether and how PSC differed among NH staff (Managers, Nurses, Direct Care Staff, Support Staff, Administrative Staff and Other Providers) in the Autonomous Province of Trento, Italy. This study employed a cross-sectional design and collected data from 1145 NH providers using the Nursing Home Survey on Patient Safety Culture (NHSPSC). Data were analyzed using linear mixed models, with each of the 12 NHSPSC domains as a response variable. The majority of the respondents (61.6%) were Direct Care Staff members. ‘Feedback and Communication about Incidents’ and ‘Overall Perceptions of Resident Safety’ were the domains with the highest proportions of positive answers (PPAs). For most staff categories, ‘Staffing’ was the domain with the lowest PPA. Support Staff showed significantly lower scores in the majority of domains (8/12). Shorter job tenure, fewer weekly working hours, working mostly during the day and working in highly specialized areas were associated with higher scores in several domains. Interventions to improve PSC must consider the differences between professional groups. Further research is needed to explore the relationship between job-related features and perceptions of patient safety among NH workers.

Nodular gill disease in Northeastern Italy: An investigation on the prevalence of the disease and the risks of introduction in rainbow trout farms.

Nodular Gill Disease (NGD) is an emerging pathogenic condition that causes gill damage and mainly affects farmed freshwater fish, rainbow trout (Oncorhynchus mykiss) in particular, and this inevitably generates noticeable economic losses for the industry. The present study aimed to assess the prevalence of NGD in the Autonomous Province of Trento, a highly productive area located in Northeastern Italy, traditionally suited to rainbow trout production, and to identify possible risk factors for the introduction of this disease in trout farms. The necessary data were obtained through a questionnaire and the collection of fish samples. According to the data analysis, 42% of the investigated farms tested positive for NGD. The two possible risk factors identified for its introduction in farms are the presence of other diseases in the same farm (OR = 17.5; 95% CI = 2.7; 111.5) and having farms located 5 km upstream (OR = 24.8; 95% CI = 2.9; 211.1). These results highlight (i) a possible impairment of the immune system caused by other diseases as a predisposing factor to the manifestation of the pathology and (ii) the role of water in spreading pathogens.

Morphodynamics and sediment connectivity index in an unmanaged, debris-flow prone catchment: a through time perspective

Torrential processes are among the main actors responsible for sediment production and mobility in mountain catchments. For this reason, the understanding of preferential pathways for sediment routing has become a priority in hazard assessment and mitigation. In this context, the sediment Connectivity Index (IC) enables to analyse the existing linkage between sediment sources and the selected target (channel network or catchment outlet). The IC is a grid-based index that allows fast computation of sediment connectivity based on landscape information derived from a single Digital Terrain Model (DTM). The index computation is based on the log-ratio between an upslope and a downslope component, including information about drainage area, slope, terrain roughness, and distance to the analysis target (e.g. outlet). The output is a map that highlights the degree of structural connectivity of sediment pathways over analysed catchments. Until now, these maps are however rarely used to help defining debris-flow hazard maps, notably due to a lack of guidelines to interpret the IC spatial distribution. This paper proposes an exploitation procedure along profiles to extract more information from the analysis of mapped IC values. The methodology relies on the analysis of the IC and its component variables along the main channel profile, integrated with information about sediment budgeting derived from Difference of DEMs (DoD). The study of connectivity was applied in the unmanaged sub-catchment (without torrent control works) of the Rio Soial (Autonomous Province of Trento – NE Italy) to understanding the geomorphic evolution of the area after five debris flows (in ten years) and the related changes of sediment connectivity. Using a recent DTM as validation, we demonstrated how an IC analysis over the older DTM can help predicting geomorphic changes and associated hazards. The results show an IC aptitude to capture geomorphic trajectories, anticipate debris flow deposits in a specific channel location, and depict preferential routing pathways..

Prevalence of gestational diabetes and recourse to postpartum oral glucose tolerance test in the Autonomous Province of Trento (Italy)

ObjectiveThe occurrence of gestational diabetes (GDM) is increasing worldwide, and such a diagnosis is important for women's health beyond pregnancy. Therefore, many guidelines suggest the re-evaluation of glucose tolerance with a postpartum oral glucose tolerance test (OGTT) in women with GDM. This study reports the prevalence of GDM and the use of a postpartum OGTT in women assisted at maternity units in the Autonomous Province of Trento in the years 2017–2018, investigating the socio-demographic and health-care variables that can facilitate access to the test. Study designFor the diagnosis of GDM, the International Association of Diabetes and Pregnancy Study Group criteria were used. The Birth Assistance Certificate and the Hospital Information System were used to retrieve clinical and socio-demographic data. Univariate and multivariate analyses were performed to evaluate the stratification of the use of a postpartum OGTT. ResultsIn total, 8,308 pregnant women were assisted at the maternity units in Trento. There were 532 recorded cases of GDM (266 cases per year) and the overall average prevalence was 6.4 % (95 % CI, 5.90–6.90), 4.9 % of whom were Italian (95 % CI, 4.38–5.42) and 10.4 %, foreigners (95 % CI, 9.13–11.67).135 women diagnosed with GDM and residing in Trento out of 513 were evaluated using a postpartum OGTT (26.3%, CI 95% 22.50–30.10), with pathological results in 61 cases (45.2%). In the multivariate analyses, insulin therapy during pregnancy, delivery at a third-level birth point, and a discharge letter informing of the presence of GDM and of the need for a postpartum OGTT were independent factors associated with the probability of carrying out a postpartum OGTT. ConclusionsThe prevalence of GDM in our study is lower than in previous Italian studies; however, it is consistent with European data. The proportion of women who were assessed using the postpartum OGTT is lower than that reported by previous studies. The health-care factors seem predominant among the socio-demographic characteristics of the cases in influencing access to the test. The awareness of women, the sharing of guidelines among the different sectors of the health system, and an optimal management of the discharge from the birth point are critical in ensuring an optimal follow-up in women with GDM.

Rural–Urban Metabolism: A Methodological Approach for Carbon-Positive and Circular Territories

Cities are responsible for about 75% of the global greenhouse gas emissions. Various materials and energy sources, which are mostly produced by the rural areas rather than the cities, are consumed by the cities, and their waste is released back into the rural areas, thereby causing evident environmental damages. The Rural–Urban Metabolism approach can offer a comprehensive tool to understand the flux of resources that cross the urban environments and plan for more sustainable cities. Considering the strength of the relationship between the urban and rural areas, this paper offers a new perspective regarding the Rural–Urban Metabolism and its application in the Autonomous Province of Trento is discussed. The methodological approach consists of four main steps: data collection and management to support strategic territorial/urban plans; data assessment to critically evaluate the existing context; data mapping to visualize the data and territorial dynamics; and finally, the definition of the strategic and integrated development plan and actions. The Rural–Urban Metabolism proved to be a strategic approach for urban planning and design to monitor the flow of it, assess the impacts of it and promote more sustainable and circular urban policies.

Walking around the Autonomous Province of Trento (Italy): An Ethnobotanical Investigation.

The Trentino-South Tyrol region is a special statute region of northeastern Italy. This territory is of particular interest for its morphology, flourishing vegetation, and history, having been a meeting area among different civilizations. Hence, Trentino is characterized by an ethnic plurality and a rich ethnobotanical knowledge, even if the available information is fragmentary, widely dispersed, and often guarded in oral popular culture. To fill this gap, in the present work 200 subjects were interviewed using an ethnobotanical survey. The resulting 817 citations referred to 64 native species, used either for human or animal health or for domestic purposes. As a second step, for each plant exploited for medicinal purposes, local importance was evaluated by calculating their relative frequency of citation. Moreover, the main traditional preparations were discussed. Among them, the most cited and exploited ones are Achillea millefolium, Arnica montana, Hypericum perforatum, Malva sylvestris, Pinus mugo, and Satureja montana, for which a deeper analysis has been performed. Lastly, the ethnobotanical knowledge of the plants growing in this territory will add a piece to the mosaic of traditional medicine in Italy and may lay the foundation for a nature-aided drug discovery process.

Farmers' participation in the Income Stabilisation Tool: Evidence from the apple sector in Italy

AbstractThe Income Stabilisation Tool (IST), which was recently added to the European Common Agricultural Policy's risk management toolkit, is a mutual fund that aims at stabilising farmers' income. We investigate the drivers of farmers' participation in an IST for the apple sector in the Autonomous Province of Trento in Italy, which is the only region that has operationalised the IST in the European Union. Our analysis is based on a theoretical framework based on the Unified Theory of Use and Acceptance of Technology. Using a three‐year panel dataset of 3268 farm households, we estimated a logit model with the Mundlak–Chamberlain procedure. Our results show that higher crop production specialisation, associated with greater risk exposure, favours participation in the IST. Similarly, previous experience with mutual funds increases the acceptance of the IST. The analysis also provides evidence of how the new tool interacts with existing on‐farm protection strategies, leading to a discussion of the presence of adverse and advantageous selection effects. Our paper sheds light on farmers' acceptance of newly implemented sector‐specific ISTs and generates better knowledge and understanding of lock‐ins and levers that influence participation in such schemes, which are relevant to other EU regions or member states that are considering the introduction of ISTs.

The Development of Cognitive and Noncognitive Skills in Students in the Autonomous Province of Trento

The analysis of what human capital (HC) is has a long history and culminates in the acknowledgment that HC and its growth are very important for both cognitive education (cognitive skills (CSs)) and personal life (noncognitive skills (NCSs)) and that CSs and NCSs have a strong reciprocal relationship, as studies by Heckman demonstrated. The present contribution (following Heckman’s approach) analyzed the relationship between CSs and NCSs in a sample of middle school students in the Autonomous Province of Trento. The second goal of the research was to verify whether educational teaching behaviors improved students’ personalities. Aside from the use of administrative data (INVALSI data, 2015 and 2018), one survey was administered in the 2018–2019 schooling year to verify the relationship between NCSs and CSs. Moreover, we sought to determine whether education teaching behavior improved the students’ personalities (1522 students in 25 schools) and whether programs could enhance NCSs. Methodological tools for the analysis involved the generalized least squares approach to answer the first question and a difference-in-differences model for the second. The main results showed that the levels of NCSs affected the ability to learn and improve CSs; a challenging teaching approach, especially if accompanied by programs improving its quality, had positive results. Finally, the research suggested that a wider, national-based survey following students from primary to secondary school would allow for a greater understanding of the dynamics of CSs and NCSs.

Priority actions of the different Regional Prevention Plans: common features and innovations


 The National Prevention Plan (NPP) 2010-2012, approved by the Agreement between the Government, the Regions and Autonomous Provinces of Trento and Bolzano on 29 April 2010, called for Regions to adopt, by 31/12/2010, the Regional Prevention Plan (RPP) for implementing the interventions provided by the NPP 2010-2012.
 This article has considered and compared the different RPP’s. In an attempt to provide an outlook on the future medical prevention plans over the next few years in Italy, a comparison has been made between the RPP from 19 Regions and the Autonomous Province of Trento. This work has been focused on the actions identified in regional plans as a priority concerning the major common and innovative elements.
 The analysis of each RPP revealed a common plan to chronic degenerative diseases, because of the aging of the population in every Region of Italy. Other important common targets are: surveillance systems, vaccination programs and screening programs. Toscana and Liguria, more than other Regions, are engaged in the creation of networks involving various social actors. In some Regions there are projects aimed at eliminating social, economic or gender inequities, such as the project “women’s health” in the Region of Puglia. Toscana and Emilia-Romagna Plans pay attention to environment and pollution issues.
 Despite social, environmental and economic differences, the various Regions have common principles, concerning: life style, surveillance, vaccination and the screening for cancer.

The relevance of citizen involvement in Health Technology Assessment. A concrete application in the assessment of HPV co-testing in the Autonomous Province of Trento


 Background
 Specific programs have been developed in the latest decades to involve patients in Health Technology Assessments (HTAs). However, there are no structured practises in Italy and citizen’ perspective is rarely included in HTA reports. Aim of this study is to explore citizen’ opinions about cervical cancer screening with Human Papillomavirus (HPV) co-testing in the Autonomous Province of Trento (PAT).
 Methods
 Two focus groups were conducted: one with representatives of patients’ associations, the other one with women between 31 and 64 years and their family members. Following aspects were investigated: the importance of cervical cancer screening programs; the impact of HPV test on women’ and their partners’ life; needs, expectations, and critical aspects of the new screening method.
 Results
 Organised screening programs are very important for all participants. HPV co-testing screening is preferred to cytology for its higher sensitivity, but different opinions came out regarding the longer screening interval after normal HPV and Pap test results. Citizen stressed that correct, clear, and unambiguous information have to be provided to the whole population (men included). A cardinal role plays the patient-doctor relationship in informing and taking care, also emotionally, of women, their partners and relatives in case of positive HPV test.
 Conclusion
 In order to facilitate the introduction of the new screening method, various media must be used to spread clear and unambiguous information, as well as informative and educational meetings with doctors and caregivers. Citizen perspective was included in the report for the Health Trust and played an important role in the decision process.

The TeMP_cardio Model for the district management of heart failure patients: a feasibility study for the implementation of the family nurse

The need to enhance primary health nursing care and chronic disease management requires the development of complex and feasible models in local contexts. To test the feasibility of a complex care model, based on the introduction of the family and community nurse for patients with stable heart failure and their caregivers. A pre-post six-month feasibility study was conducted in 2021-2022 in the Autonomous Province of Trento. Patients with stable heart failure able to access services were taken in charge with a multidisciplinary model, with the nurse as care manager, and technological and telemonitoring support. 26 patients out of 137 were included and nine of their caregivers. Ten participants accepted to use the mobile app. Twenty-three patients and seven caregivers completed the study, and the app was used regularly by five participants. Self-care skills improved in patients, mostly in self-monitoring, less in caregivers. One access to the emergency department for heart failure exacerbation was detected. The model was evaluated feasible to retain patients, with the need to build effective strategies for the recruitment, and the regular use of telemonitoring tools.