Impact of Home Patient Telemonitoring on Use of β-Blockers in Congestive Heart Failure

Abstract

This study showed that a home-care model including telemonitoring of relevant clinical parameters may provide useful support in the management of patients with CHF. Home telemonitoring in CHF patients was associated with increased use of β-blockers at appropriate doses, suggesting that this strategy reassured physicians regarding the safety of careful use of these agents in this setting. However, larger studies are required to confirm these findings. Our findings indicate that there is a need to investigate relevant parameters in CHF patients at the point of care (i.e. in patients' daily lives), which can in turn optimize β-blocker and other drug therapy.

A Novel Intelligent Two-Way Communication System for Remote Heart Failure Medication Uptitration (the CardioCoach Study): Randomized Controlled Feasibility Trial (Preprint)

“…The success rate of studies monitoring weight, blood pressure and heart rate to improve clinical outcome is rather low, probably because they are unable to capture the complexity of HF disease progression which often involves multiple comorbidities [28][29][30][31][32][33]. However, the possible added value in terms of medication uptitration, has only recently been studied and forms the objective of the current research [21,26].…”

“…Hence remote monitoring of vital parameters and other patient information allows to remotely adapt and evaluate patients' medication schemes according to ESC guidelines [21]. Remote β-blocker uptitration based on patients self-collected physiologic data (weight, pulse and blood pressure) transmitted by phone has been previously studied and showed a positive impact on β-blocker use [21][22][23].…”

“…Remote β-blocker uptitration based on patients self-collected physiologic data (weight, pulse and blood pressure) transmitted by phone has been previously studied and showed a positive impact on β-blocker use [21][22][23]. The IN-TOUCH trial was one of the first to study the value of a decision support algorithm for medication uptitration on top of remote monitoring (i.e.…”

A multimodal technology intervention for heart failure patients to reduce readmissions

“…These limitations may lead to disengagement and/or measurement error. [40] In a recent study by Sanders, et al, [41] patients who refused to participate in the HT research study discussed concerns about technical competence and specials skills that were needed to operate the equipment, but most were based on misunderstanding. The use of HT in the end-stages of heart failure has not been well researched [42] and the use of HT in the palliative setting is considered controversial.…”

“…[43] Patients who are nearing the end-of-life can be inappropriate for home HT; palliative care support services are more important, and the HT device may be perceived as intrusive. [37,41] More research is needed to determine the ideal patient characteristics, technology, parameters, frequency, and duration of HT.…”