Telemedical Care and Monitoring for Patients with Chronic Heart Failure Has a Positive Effect on Survival

Background Telemedical care and monitoring programs for patients with chronic heart failure have shown beneficial effects on survival in several small studies. The utility in routine care remains unclear. Methods We evaluated a large‐sized telemedicine program in a routine care setting, enrolling in...

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Published inHealth services research Vol. 53; no. 1; pp. 532 - 555
Main Authors Herold, Robert, Berg, Neeltje, Dörr, Marcus, Hoffmann, Wolfgang
Format Journal Article
LanguageEnglish
Published United States Health Research and Educational Trust 01.02.2018
Blackwell Publishing Ltd
John Wiley and Sons Inc
Subjects
Age
Aged
Aged, 80 and over
Analysis
Beta blockers
Body Weight
Cardiac patients
Care and treatment
Chronic Disease
Chronic heart failure
Clinical trials
Counseling - methods
Female
Health insurance industry
Heart
Heart diseases
Heart failure
Heart Failure - mortality
Heart Failure - physiopathology
Heart Failure - therapy
Humans
Intervention
Male
Mentors
Monitoring, Ambulatory - methods
National health insurance
Patient Compliance
Patient Education as Topic
Patient monitoring equipment
Patient outcomes
Patients
Primary Care and Chronic Disease Management
Propensity
Propensity Score
propensity score matching
reimbursement data
Remote monitoring
routine data
Survival
telemedical care
telemedical monitoring
Telemedicine
Telemedicine - methods
Germany
propensity score matching
routine data
reimbursement data
telemedical care
telemedical monitoring
Chronic heart failure
Online AccessGet full text
ISSN0017-9124
1475-6773
1475-6773
DOI10.1111/1475-6773.12661

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Abstract Background Telemedical care and monitoring programs for patients with chronic heart failure have shown beneficial effects on survival in several small studies. The utility in routine care remains unclear. Methods We evaluated a large‐sized telemedicine program in a routine care setting, enrolling in total 2,622 patients (54.7 percent male, mean age: 73.7 years) with chronic heart failure. We used reimbursement data from a large statutory health insurance and approached a matched control analysis. In a complex propensity score matching procedure, 3,719 suitable controls (54.2 percent male, mean age: 74.5 years) were matched to 1,943 intervention patients (54.1 percent male, mean age: 74.4 years). The primary endpoint of our analysis was survival after 1 year. Results Analyses revealed a higher survival probability among subjects of the intervention group compared to controls group after 1 year (adjusted OR: 1.47, CI 95 percent: 1.21–1.80, p < .001) and 2 years (adjusted OR: 1.51, CI 95 percent: 1.28–1.77, p < .001), respectively. Conclusions The probabilities to survive after 1 and 2 years were significantly increased in the intervention group. Our findings confirm previous results of controlled trials and importantly indicate that patients with chronic heart failure may benefit from telemonitoring programs in routine care.
AbstractList BackgroundTelemedical care and monitoring programs for patients with chronic heart failure have shown beneficial effects on survival in several small studies. The utility in routine care remains unclear.MethodsWe evaluated a large‐sized telemedicine program in a routine care setting, enrolling in total 2,622 patients (54.7 percent male, mean age: 73.7 years) with chronic heart failure. We used reimbursement data from a large statutory health insurance and approached a matched control analysis. In a complex propensity score matching procedure, 3,719 suitable controls (54.2 percent male, mean age: 74.5 years) were matched to 1,943 intervention patients (54.1 percent male, mean age: 74.4 years). The primary endpoint of our analysis was survival after 1 year.ResultsAnalyses revealed a higher survival probability among subjects of the intervention group compared to controls group after 1 year (adjusted OR: 1.47, CI 95 percent: 1.21–1.80, p < .001) and 2 years (adjusted OR: 1.51, CI 95 percent: 1.28–1.77, p < .001), respectively.ConclusionsThe probabilities to survive after 1 and 2 years were significantly increased in the intervention group. Our findings confirm previous results of controlled trials and importantly indicate that patients with chronic heart failure may benefit from telemonitoring programs in routine care.
Telemedical care and monitoring programs for patients with chronic heart failure have shown beneficial effects on survival in several small studies. The utility in routine care remains unclear. We evaluated a large-sized telemedicine program in a routine care setting, enrolling in total 2,622 patients (54.7 percent male, mean age: 73.7 years) with chronic heart failure. We used reimbursement data from a large statutory health insurance and approached a matched control analysis. In a complex propensity score matching procedure, 3,719 suitable controls (54.2 percent male, mean age: 74.5 years) were matched to 1,943 intervention patients (54.1 percent male, mean age: 74.4 years). The primary endpoint of our analysis was survival after 1 year. Analyses revealed a higher survival probability among subjects of the intervention group compared to controls group after 1 year (adjusted OR: 1.47, CI 95 percent: 1.21-1.80, p < .001) and 2 years (adjusted OR: 1.51, CI 95 percent: 1.28-1.77, p < .001), respectively. The probabilities to survive after 1 and 2 years were significantly increased in the intervention group. Our findings confirm previous results of controlled trials and importantly indicate that patients with chronic heart failure may benefit from telemonitoring programs in routine care.
Background. Telemedical care and monitoring programs for patients with chronic heart failure have shown beneficial effects on survival in several small studies. The utility in routine care remains unclear. Methods. We evaluated a large-sized telemedicine program in a routine care setting, enrolling in total 2,622 patients (54.7 percent male, mean age: 73.7 years) with chronic heart failure. We used reimbursement data from a large statutory health insurance and approached a matched control analysis. In a complex propensity score matching procedure, 3,719 suitable controls (54.2 percent male, mean age: 74.5 years) were matched to 1,943 intervention patients (54.1 percent male, mean age: 74.4 years). The primary endpoint of our analysis was survival after 1 year. Results. Analyses revealed a higher survival probability among subjects of the intervention group compared to controls group after 1 year (adjusted OR: 1.47, CI 95 percent: 1.21-1.80, p < .001) and 2 years (adjusted OR: 1.51, CI 95 percent: 1.28-1.77, p < .001), respectively. Conclusions. The probabilities to survive after 1 and 2 years were significantly increased in the intervention group. Our findings confirm previous results of controlled trials and importantly indicate that patients with chronic heart failure may benefit from telemonitoring programs in routine care. Key Words. Chronic heart failure, telemedical care, telemedical monitoring, reimbursement data, routine data, propensity score matching
Background Telemedical care and monitoring programs for patients with chronic heart failure have shown beneficial effects on survival in several small studies. The utility in routine care remains unclear. Methods We evaluated a large‐sized telemedicine program in a routine care setting, enrolling in total 2,622 patients (54.7 percent male, mean age: 73.7 years) with chronic heart failure. We used reimbursement data from a large statutory health insurance and approached a matched control analysis. In a complex propensity score matching procedure, 3,719 suitable controls (54.2 percent male, mean age: 74.5 years) were matched to 1,943 intervention patients (54.1 percent male, mean age: 74.4 years). The primary endpoint of our analysis was survival after 1 year. Results Analyses revealed a higher survival probability among subjects of the intervention group compared to controls group after 1 year (adjusted OR: 1.47, CI 95 percent: 1.21–1.80, p < .001) and 2 years (adjusted OR: 1.51, CI 95 percent: 1.28–1.77, p < .001), respectively. Conclusions The probabilities to survive after 1 and 2 years were significantly increased in the intervention group. Our findings confirm previous results of controlled trials and importantly indicate that patients with chronic heart failure may benefit from telemonitoring programs in routine care.
Telemedical care and monitoring programs for patients with chronic heart failure have shown beneficial effects on survival in several small studies. The utility in routine care remains unclear.BACKGROUNDTelemedical care and monitoring programs for patients with chronic heart failure have shown beneficial effects on survival in several small studies. The utility in routine care remains unclear.We evaluated a large-sized telemedicine program in a routine care setting, enrolling in total 2,622 patients (54.7 percent male, mean age: 73.7 years) with chronic heart failure. We used reimbursement data from a large statutory health insurance and approached a matched control analysis. In a complex propensity score matching procedure, 3,719 suitable controls (54.2 percent male, mean age: 74.5 years) were matched to 1,943 intervention patients (54.1 percent male, mean age: 74.4 years). The primary endpoint of our analysis was survival after 1 year.METHODSWe evaluated a large-sized telemedicine program in a routine care setting, enrolling in total 2,622 patients (54.7 percent male, mean age: 73.7 years) with chronic heart failure. We used reimbursement data from a large statutory health insurance and approached a matched control analysis. In a complex propensity score matching procedure, 3,719 suitable controls (54.2 percent male, mean age: 74.5 years) were matched to 1,943 intervention patients (54.1 percent male, mean age: 74.4 years). The primary endpoint of our analysis was survival after 1 year.Analyses revealed a higher survival probability among subjects of the intervention group compared to controls group after 1 year (adjusted OR: 1.47, CI 95 percent: 1.21-1.80, p < .001) and 2 years (adjusted OR: 1.51, CI 95 percent: 1.28-1.77, p < .001), respectively.RESULTSAnalyses revealed a higher survival probability among subjects of the intervention group compared to controls group after 1 year (adjusted OR: 1.47, CI 95 percent: 1.21-1.80, p < .001) and 2 years (adjusted OR: 1.51, CI 95 percent: 1.28-1.77, p < .001), respectively.The probabilities to survive after 1 and 2 years were significantly increased in the intervention group. Our findings confirm previous results of controlled trials and importantly indicate that patients with chronic heart failure may benefit from telemonitoring programs in routine care.CONCLUSIONSThe probabilities to survive after 1 and 2 years were significantly increased in the intervention group. Our findings confirm previous results of controlled trials and importantly indicate that patients with chronic heart failure may benefit from telemonitoring programs in routine care.
Audience Trade
Author Herold, Robert
Berg, Neeltje
Hoffmann, Wolfgang
Dörr, Marcus
AuthorAffiliation 3 Department of Internal Medicine B and the DZHK (German Centre for Cardiovascular Research) University Medicine Greifswald, Partner Site Greifswald Greifswald Germany
1 Institute for Community Medicine University Medicine Greifswald Greifswald Germany
2 Institute for Community Medicine University Medicine Greifswald and the DZHK (German Centre for Cardiovascular Research) Partner Site Greifswald Greifswald Germany
AuthorAffiliation_xml – name: 2 Institute for Community Medicine University Medicine Greifswald and the DZHK (German Centre for Cardiovascular Research) Partner Site Greifswald Greifswald Germany
– name: 1 Institute for Community Medicine University Medicine Greifswald Greifswald Germany
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  surname: Herold
  fullname: Herold, Robert
  email: robert.herold@uni-greifswald.de
  organization: University Medicine Greifswald
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  givenname: Neeltje
  surname: Berg
  fullname: Berg, Neeltje
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  fullname: Dörr, Marcus
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  givenname: Wolfgang
  surname: Hoffmann
  fullname: Hoffmann, Wolfgang
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routine data
reimbursement data
telemedical care
telemedical monitoring
Chronic heart failure
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Snippet Background Telemedical care and monitoring programs for patients with chronic heart failure have shown beneficial effects on survival in several small studies....
Telemedical care and monitoring programs for patients with chronic heart failure have shown beneficial effects on survival in several small studies. The...
Background. Telemedical care and monitoring programs for patients with chronic heart failure have shown beneficial effects on survival in several small...
BackgroundTelemedical care and monitoring programs for patients with chronic heart failure have shown beneficial effects on survival in several small studies....
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StartPage 532
SubjectTerms Age
Aged
Aged, 80 and over
Analysis
Beta blockers
Body Weight
Cardiac patients
Care and treatment
Chronic Disease
Chronic heart failure
Clinical trials
Counseling - methods
Female
Health insurance industry
Heart
Heart diseases
Heart failure
Heart Failure - mortality
Heart Failure - physiopathology
Heart Failure - therapy
Humans
Intervention
Male
Mentors
Monitoring, Ambulatory - methods
National health insurance
Patient Compliance
Patient Education as Topic
Patient monitoring equipment
Patient outcomes
Patients
Primary Care and Chronic Disease Management
Propensity
Propensity Score
propensity score matching
reimbursement data
Remote monitoring
routine data
Survival
telemedical care
telemedical monitoring
Telemedicine
Telemedicine - methods
Title Telemedical Care and Monitoring for Patients with Chronic Heart Failure Has a Positive Effect on Survival
URI https://onlinelibrary.wiley.com/doi/abs/10.1111%2F1475-6773.12661
https://www.ncbi.nlm.nih.gov/pubmed/28138988
https://www.proquest.com/docview/1990978649
https://www.proquest.com/docview/1863219241
https://pubmed.ncbi.nlm.nih.gov/PMC5785302
Volume 53
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