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

• Published in: Health services research Vol. 53; no. 1; pp. 532 - 555
• Main Authors: Herold, Robert, Berg, Neeltje, Dörr, Marcus, Hoffmann, Wolfgang
• Format: Journal Article
• Language: English
• 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
• ISSN: 0017-9124; 1475-6773; 1475-6773
• DOI: 10.1111/1475-6773.12661

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.