Title |
The value of telemonitoring and ICT-guided disease management in heart failure: Results from the IN TOUCH study
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Published in |
International Journal of Medical Informatics, October 2015
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DOI | 10.1016/j.ijmedinf.2015.10.001 |
Pubmed ID | |
Authors |
Imke Kraai, Arjen de Vries, Karin Vermeulen, Vincent van Deursen, Martje van der Wal, Richard de Jong, René van Dijk, Tiny Jaarsma, Hans Hillege, Ivonne Lesman |
Abstract |
It is still unclear whether telemonitoring reduces hospitalization and mortality in heart failure (HF) patients and whether adding an Information and Computing Technology-guided-disease-management-system (ICT-guided-DMS) improves clinical and patient reported outcomes or reduces healthcare costs. A multicenter randomized controlled trial was performed testing the effects of INnovative ICT-guided-DMS combined with Telemonitoring in OUtpatient clinics for Chronic HF patients (IN TOUCH) with in total 179 patients (mean age 69 years; 72% male; 77% in New York Heart Association Classification (NYHA) III-IV; mean left ventricular ejection fraction was 28%). Patients were randomized to ICT-guided-DMS or to ICT-guided-DMS+telemonitoring with a follow-up of nine months. The composite endpoint included mortality, HF-readmission and change in health-related quality of life (HR-QoL). In total 177 patients were eligible for analyses. The mean score of the primary composite endpoint was -0.63 in ICT-guided-DMS vs. -0.73 in ICT-guided-DMS+telemonitoring (mean difference 0.1, 95% CI: -0.67 +0.82, p=0.39). All-cause mortality in ICT-guided-DMS was 12% versus 15% in ICT-guided-DMS+telemonitoring (p=0.27); HF-readmission 28% vs. 27% p=0.87; all-cause readmission was 49% vs. 51% (p=0.78). HR-QoL improved in most patients and was equal in both groups. Incremental costs were €1360 in favor of ICT-guided-DMS. ICT-guided-DMS+telemonitoring had significantly fewer HF-outpatient-clinic visits (p<0.01). ICT-guided-DMS+telemonitoring for the management of HF patients did not affect the primary and secondary endpoints. However, we did find a reduction in visits to the HF-outpatient clinic in this group suggesting that telemonitoring might be safe to use in reorganizing HF-care with relatively low costs. |
X Demographics
Geographical breakdown
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United Arab Emirates | 1 | 100% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 1 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Netherlands | 2 | 1% |
Switzerland | 1 | <1% |
Unknown | 173 | 98% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Master | 30 | 17% |
Student > Ph. D. Student | 23 | 13% |
Student > Bachelor | 23 | 13% |
Researcher | 16 | 9% |
Other | 9 | 5% |
Other | 34 | 19% |
Unknown | 41 | 23% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 40 | 23% |
Nursing and Health Professions | 31 | 18% |
Computer Science | 12 | 7% |
Social Sciences | 8 | 5% |
Economics, Econometrics and Finance | 7 | 4% |
Other | 32 | 18% |
Unknown | 46 | 26% |