PMID- 23758079
OWN - NLM
STAT- MEDLINE
DCOM- 20140506
LR  - 20191210
IS  - 1556-3669 (Electronic)
IS  - 1530-5627 (Linking)
VI  - 19
IP  - 8
DP  - 2013 Aug
TI  - Home-based telesurveillance program in chronic heart failure: effects on clinical 
      status and implications for 1-year prognosis.
PG  - 605-12
LID - 10.1089/tmj.2012.0250 [doi]
AB  - BACKGROUND: Studies focusing on the effects of telemanagement programs for 
      chronic heart failure (CHF) on functional status are lacking, and the prognostic 
      value of the clinical response to the programs is unknown. In the Lombardy region 
      of Italy, a home-based telesurveillance program (HTP) including multidisciplinary 
      management and remote telemonitoring for patients with CHF was introduced in 2000 
      and was formally adopted, as part of the services delivered by the regional 
      healthcare system, in 2006. This article reports the effect of the HTP on the 
      functional status and quality of life and describes the main outcomes observed 
      within 1 year from the end of the program. MATERIALS AND METHODS: Six-month 
      variations of New York Heart Association (NYHA) class, left ventricular ejection 
      fraction (LVEF), 6-min walking distance (6MWD), and Minnesota Living with Heart 
      Failure Questionnaire (MLHFQ) score were evaluated in 602 CHF patients. Patients 
      showing at least two of the following conditions-NYHA class reduction, increase 
      in LVEF >/=5%, 6MWD >30 m, and a reduction of >24 points of MLHFQ-were defined as 
      "responders." One-year events included unplanned cardiovascular readmissions and 
      mortality. RESULTS: A significant improvement in NYHA class, LVEF, 6MWD, and 
      MLHFQ was observed. Clinical events occurred in 24.1% of non-responders and in 
      15.9% of responders (p=0.03). An unfavorable response to the program, the 
      presence of an implantable cardioverter defibrillator, and multiple comorbidities 
      were predictors of poor outcome. CONCLUSIONS: The HTP was effective in improving 
      CHF patient functional status, and an unsuccessful response to the intervention 
      seems to be an independent marker of poor prognosis.
FAU - Giordano, Amerigo
AU  - Giordano A
AD  - Institute of Care and Scientific Research, Salvatore Maugeri Foundation, 
      Lumezzane, Brescia, Italy. amerigo.giordano@fsm.it
FAU - Scalvini, Simonetta
AU  - Scalvini S
FAU - Paganoni, Anna Maria
AU  - Paganoni AM
FAU - Baraldo, Stefano
AU  - Baraldo S
FAU - Frigerio, Maria
AU  - Frigerio M
FAU - Vittori, Claudia
AU  - Vittori C
FAU - Borghi, Gabriella
AU  - Borghi G
FAU - Marzegalli, Maurizio
AU  - Marzegalli M
FAU - Agostoni, Ornella
AU  - Agostoni O
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20130612
PL  - United States
TA  - Telemed J E Health
JT  - Telemedicine journal and e-health : the official journal of the American 
      Telemedicine Association
JID - 100959949
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Heart Failure/physiopathology/*therapy
MH  - *Home Care Services
MH  - Humans
MH  - Italy
MH  - Male
MH  - Middle Aged
MH  - *Outcome Assessment, Health Care
MH  - Quality of Life
MH  - *Remote Sensing Technology
MH  - *Telemedicine
EDAT- 2013/06/14 06:00
MHDA- 2014/05/07 06:00
CRDT- 2013/06/14 06:00
PHST- 2013/06/14 06:00 [entrez]
PHST- 2013/06/14 06:00 [pubmed]
PHST- 2014/05/07 06:00 [medline]
AID - 10.1089/tmj.2012.0250 [doi]
PST - ppublish
SO  - Telemed J E Health. 2013 Aug;19(8):605-12. doi: 10.1089/tmj.2012.0250. Epub 2013 
      Jun 12.