Impact on clinical events and healthcare costs of adding telemedicine to multidisciplinary disease management programmes for heart failure: Results of a randomized controlled trial

Comín‐Colet, Josep; Enjuanes, Cristina; Verdú-Rotellar, José María; Linas, Anna; Ruiz-Rodriguez, Pilar; González-Robledo, Gina; Farré, Núria; Moliner-Borja, Pedro; Ruíz-Bustillo, Sonia; Bruguera, Jordi

doi:10.1177/1357633x15600583

Cited by 104 publications

(159 citation statements)

References 23 publications

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“…There is emphasis on the high level of satisfaction shown by patients who are part of the project, as they feel better controlled and safer. This data confirms the feasibility of a telemedicine project in chronic elderly patients, despite their limited experience in the use of electronic devices [39][40][41][42].…”

Section: Conclusion and Discussionsupporting

confidence: 64%

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Application of Telemedicine for the Optimal Control of Asthma Patients

Cano¹,

Agustín²,

Royo³

et al. 2016

J Pulm Respir Med

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Section: Conclusion and Discussionsupporting

confidence: 64%

“…Also hospital readmission for any cause and the average number of days in the hospital was significantly reduced. In addition, the study we have shown that the efficiency of telemedicine was independent of education level, the severity of HF, the presence of depressive symptoms or the fragility of the patient [40][41][42].…”

Section: Conclusion and Discussionmentioning

confidence: 96%

Application of Telemedicine for the Optimal Control of Asthma Patients

Cano¹,

Agustín²,

Royo³

et al. 2016

J Pulm Respir Med

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“…17,18 In this type of unit or program, a variety of interventions may be carried out (education, follow-up, treatment, social support) from those that have been demonstrated to improve quality of life, reduce the number of hospital admissions for HF and for all causes, and even reduce mortality. 5,6 This reduction in hospital admissions 4,14,15,[19][20][21] and improved survival have also been demonstrated in Spain.…”

Section: Introductionmentioning

confidence: 72%

“…Most HFUs combine several of these interventions. [4][5][6][7][13][14][15][16] The increasing use of these care systems has been perceived favorably due to the initial results from many studies and meta-analyses, 5,6 leading to their level IA recommendation in clinical practice guidelines. 17,18 In this type of unit or program, a variety of interventions may be carried out (education, follow-up, treatment, social support) from those that have been demonstrated to improve quality of life, reduce the number of hospital admissions for HF and for all causes, and even reduce mortality.…”

Section: Introductionmentioning

confidence: 99%

“…Theoretically, these models help ensure that the scientific evidence is applied homogeneously without variation, thereby helping to raise the bar for quality of care and increase the equity of our health care system. [4][5][6][7][13][14][15] Within the general framework of HFUs, multiple models of care have been described, ranging from a single educational session before discharge or a single educational home visit by a specialist nurse and regular telephone follow-up to a multidisciplinary intervention centralized in a physical unit, with or without interaction with primary care (PC). Most HFUs combine several of these interventions.…”

Section: Introductionmentioning

confidence: 99%

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Transitions of Care Between Acute and Chronic Heart Failure: Critical Steps in the Design of a Multidisciplinary Care Model for the Prevention of Rehospitalization

Comín‐Colet

Enjuanes

Lupón

et al. 2016

Revista Española de Cardiología (English Edition)

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Despite advances in the treatment of heart failure, mortality, the number of readmissions, and their associated health care costs are very high. Heart failure care models inspired by the chronic care model, also known as heart failure programs or heart failure units, have shown clinical benefits in high-risk patients. However, while traditional heart failure units have focused on patients detected in the outpatient phase, the increasing pressure from hospital admissions is shifting the focus of interest toward multidisciplinary programs that concentrate on transitions of care, particularly between the acute phase and the postdischarge phase. These new integrated care models for heart failure revolve around interventions at the time of transitions of care. They are multidisciplinary and patient-centered, designed to ensure continuity of care, and have been demonstrated to reduce potentially avoidable hospital admissions. Key components of these models are early intervention during the inpatient phase, discharge planning, early postdischarge review and structured follow-up, advanced transition planning, and the involvement of physicians and nurses specialized in heart failure. It is hoped that such models will be progressively implemented across the country.

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Economic Evaluation of Quality Improvement Interventions Designed to Prevent Hospital Readmission

et al. 2017

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IMPORTANCE Quality improvement (QI) interventions can reduce hospital readmission, but little is known about their economic value. OBJECTIVE To systematically review economic evaluations of QI interventions designed to reduce readmissions. DATA SOURCES Databases searched included PubMed, Econlit, the Centre for Reviews & Dissemination Economic Evaluations, New York Academy of Medicine's Grey Literature Report, and Worldcat (January 2004 to July 2016).STUDY SELECTION Dual reviewers selected English-language studies from high-income countries that evaluated organizational or structural changes to reduce hospital readmission, and that reported program and readmission-related costs.DATA EXTRACTION AND SYNTHESIS Dual reviewers extracted intervention characteristics, study design, clinical effectiveness, study quality, economic perspective, and costs. We calculated the risk difference and net costs to the health system in 2015 US dollars. Weighted least-squares regression analyses tested predictors of the risk difference and net costs. MAIN OUTCOMES AND MEASURESMain outcomes measures included the risk difference in readmission rates and incremental net cost. This systematic review and data analysis is reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. RESULTSOf 5205 articles, 50 unique studies were eligible, including 25 studies in populations limited to heart failure (HF) that included 5768 patients, 21 in general populations that included 10 445 patients, and 4 in unique populations. Fifteen studies lasted up to 30 days while most others lasted 6 to 24 months. Based on regression analyses, readmissions declined by an average of 12.1% among patients with HF (95% CI, 8.3%-15.9%; P < .001; based on 22 studies with complete data) and by 6.3% among general populations (95% CI, 4.

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Impact on clinical events and healthcare costs of adding telemedicine to multidisciplinary disease management programmes for heart failure: Results of a randomized controlled trial

Abstract: Among patients managed in the setting of a comprehensive HF programme, the addition of telemedicine may result in better outcomes and reduction of costs.

Cited by 104 publications

References 23 publications

Application of Telemedicine for the Optimal Control of Asthma Patients

Application of Telemedicine for the Optimal Control of Asthma Patients

Transitions of Care Between Acute and Chronic Heart Failure: Critical Steps in the Design of a Multidisciplinary Care Model for the Prevention of Rehospitalization

Economic Evaluation of Quality Improvement Interventions Designed to Prevent Hospital Readmission

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