Impact of Telemedical Care and Monitoring on Morbidity in Mild to Moderate Chronic Heart Failure

Abstract

We investigated in a pilot study whether telemedicine is beneficial in mild to moderate chronic heart failure. A total of 128 patients with an ejection fraction < or =60% and NYHA class II or III chronic heart failure were evaluated. Thirty-two patients were enrolled prospectively in a staged telemedical service program. Ninety-six controls were matched 3:1 to each telemedicine patient. Median follow-up was 307 days (range 104-459). All-cause hospitalization duration [317 vs. 693 days/100 patient years; relative risk (RR) 0.46; 95% confidence interval (CI) 0.37-0.58; p < 0.0001) and rate (38 vs. 77/100 patient years; RR 0.49; 95% CI 0.25-0.95; p = 0.034) as well as cardiac hospitalization duration (49 vs. 379 days/100 patient years; RR 0.13; 95% CI 0.08-0.23; p < 0.0001] were significantly lower, cardiac hospitalization rate (11 vs. 35/100 patient years; RR 0.31; 95% CI 0.11-1.02; p = 0.058) tended to be lower in the telemedicine compared with the control group. These preliminary data suggest that telemedical care and monitoring may reduce morbidity in patients with NYHA class II and III chronic heart failure.