Non-invasive home telemonitoring system for heart failure patients: A randomized clinical trial

Abstract

Introduction: The low quality of life in heart failure patients is related to low self-care and treatment adherence. Consequently, innovative strategies are needed to improve them. The objective of this work is to determine theeffectiveness of the use of a home telemonitoring system to improve the self-care and treatment adherence of heart failure patients.Methods: A randomized clinical trial that compares the efficacy of a home telemonitoring system ?intervention group versus usual care control group ? among heart failure outpatients over a 90-day monitoring period was carried out. The home telemonitoring system consists of an application that collects measurements of different parameters on a daily basis and provides health education to patients. The home telemonitoring system processes data gathered and generates an alert if a risky situation arises. The outcomes observed were significant changes in patients? self-care (European Heart Failure Self-care Behaviour Scale), treatment adherence (Morisky Modified Scale) and re-hospitalizations over the follow-up period.Results: 104 heart failure patients were screened; 40 met the inclusion criteria; only 30 completed the study. After the follow-up, intragroup analysis of the control group indicated a decrease in treatment adherence (p¼0.02). The mean European Heart Failure Self-care Behaviour Scale overall score indicated an improved self-care in the intervention group patients (p¼0.03) and a worsened self-care in the control group (p¼0.04) with a p value of 0.004 in the intergroupanalysis. Thanks to the home telemonitoring system alerts, two re-Hospitalizations were avoided.Discussion: This study demonstrated that the proposed home telemonitoring system improves patient self-care whencompared to usual care and has the potential to avoid re-hospitalizations, even considering patients with low literacy levels.