Telemonitoring leads to a low incidence of emergency admissions among chronic heart failure patients

Abstract

Introduction

Worsening heart failure (WHF) is the leading cause of hospitalization after the age of 65 in Western countries, with a major impact on quality of life and a high cost for healthcare systems. Moreover, heart failure contributes to exacerbating the pressure on emergency departments, representing the gateway for 64% of hospital admissions for heart failure, particularly during the winter months. Telemonitoring emerges as a viable and effective strategy, enabling early identification of WHF symptoms and facilitating preventive interventions to reduce hospitalization rate.

Objective

Therefore, we aimed to describe the effect of a telemonitoring program on the rate of emergency admissions for WHF in chronic heart failure patients.

Method

All patients enrolled in the heart failure remote management program of the Clermont Ferrand and Bordeaux University Hospitals between 13 April 2020 and 31 January 2023 were included in the study. Follow-up data were collected until 31 January 2023. Inclusion criteria were chronic heart failure (HF) with New York Heart Association ≥ II and an elevated B-type natriuretic peptide (BNP > 100 pg/mL or N-terminal-pro-BNP > 1000 pg/mL). Patient assessments were performed remotely and included measurements of body weight, blood pressure, heart rate, symptoms, biochemical parameters, and data from cardiac implantable electronic devices when available.

Results

A total of 1095 patients (72 ± 11.8 years old, 69.7% male), were followed for a median [IQR] of 437 [182; 739] days with a mean adherence to the remote monitoring system of 67.6 ± 30.3%. Over this period, 168 (15.3%) patients were hospitalized for HF and 198 (18.1%) patients had 949 WHF events. One hundred and nineteen (12.5%) were not detected by telemonitoring, and 830 (87.5%) were detected, of which 703 (84.7%) were successfully managed out-of-hospital (Table 1). The remaining events required hospitalisation (n = 127, 15.3%), of which 28 (22%) required an admission to emergency department before hospitalization (Table 1).

Conclusion

Our study suggests a very low rate of hospitalizations and admissions in emergency department in a large cohort of chronic heart failure patients, using a telemonitoring program with multiparametric platform.