Benefit of Ambulatory Management of Patients with Chronic Heart Failure by Protocolized Follow-Up Therapeutic Education and Remote Monitoring Solution: An Original Study in 159 Patients
This study sought to determine whether the implementation of regular and structured follow-up of patients with chronic heart failure (CHF), combined with therapeutic education and remote monitoring solution, leads to better management. This was a single-center retrospective study conducted in a coho...
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MDPI AG
2020-09-01
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Series: | Journal of Clinical Medicine |
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Online Access: | https://www.mdpi.com/2077-0383/9/10/3106 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anne Jenneve Noel Lorenzo-Villalba Guy Courdier Samy Talha François Séverac Abrar-Ahmad Zulfiqar Patrick Arnold Philippe Lang Gérald Roul Emmanuel Andrès |
spellingShingle |
Anne Jenneve Noel Lorenzo-Villalba Guy Courdier Samy Talha François Séverac Abrar-Ahmad Zulfiqar Patrick Arnold Philippe Lang Gérald Roul Emmanuel Andrès Benefit of Ambulatory Management of Patients with Chronic Heart Failure by Protocolized Follow-Up Therapeutic Education and Remote Monitoring Solution: An Original Study in 159 Patients Journal of Clinical Medicine heart failure protocolized follow-up therapeutic education remote monitoring solution telemedicine care pathway |
author_facet |
Anne Jenneve Noel Lorenzo-Villalba Guy Courdier Samy Talha François Séverac Abrar-Ahmad Zulfiqar Patrick Arnold Philippe Lang Gérald Roul Emmanuel Andrès |
author_sort |
Anne Jenneve |
title |
Benefit of Ambulatory Management of Patients with Chronic Heart Failure by Protocolized Follow-Up Therapeutic Education and Remote Monitoring Solution: An Original Study in 159 Patients |
title_short |
Benefit of Ambulatory Management of Patients with Chronic Heart Failure by Protocolized Follow-Up Therapeutic Education and Remote Monitoring Solution: An Original Study in 159 Patients |
title_full |
Benefit of Ambulatory Management of Patients with Chronic Heart Failure by Protocolized Follow-Up Therapeutic Education and Remote Monitoring Solution: An Original Study in 159 Patients |
title_fullStr |
Benefit of Ambulatory Management of Patients with Chronic Heart Failure by Protocolized Follow-Up Therapeutic Education and Remote Monitoring Solution: An Original Study in 159 Patients |
title_full_unstemmed |
Benefit of Ambulatory Management of Patients with Chronic Heart Failure by Protocolized Follow-Up Therapeutic Education and Remote Monitoring Solution: An Original Study in 159 Patients |
title_sort |
benefit of ambulatory management of patients with chronic heart failure by protocolized follow-up therapeutic education and remote monitoring solution: an original study in 159 patients |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2020-09-01 |
description |
This study sought to determine whether the implementation of regular and structured follow-up of patients with chronic heart failure (CHF), combined with therapeutic education and remote monitoring solution, leads to better management. This was a single-center retrospective study conducted in a cohort of patients with proven CHF who were followed up in the Mulhouse region (France) between January 2016 and December 2017 by the Unité de Suivi des Patients Insuffisants Cardiaques (USICAR) unit. These patients received regular protocolized follow-up, a therapeutic education program, and several used a telemedicine platform for a two-year period. The primary endpoint was the number of days hospitalized for heart failure (HF) per patient per year. The main secondary endpoints included the number of days hospitalized for a heart condition other than HF and the number of hospital stays for HF per patient. These endpoints were collected during the year preceding enrollment, at one year of follow-up, and at two years of follow-up. The remote monitoring solution was evaluated on the same criterion. Overall, 159 patients with a mean age of 72.9 years were included in this study. They all had CHF, mainly NYHA Class I-II (88.7%), predominantly of ischemic origin (50.9%), and with altered left ventricular ejection fraction in 69.2% of cases. The mean number of days hospitalized for HF per patient per year was 8.33 (6.84–10.13) in the year preceding enrollment, 2.6 (1.51–4.47) at one year of follow-up, and 2.82 at two years of follow-up (1.30–6.11) (<i>p </i>< 0.01 for both comparisons). The mean number of days hospitalized for a heart condition other than HF was 1.73 (1.16–2.6), 1.81 (1.04–3.16), and 1.32 (0.57–3.08), respectively (<i>p </i>= ns). The percentage of hospitalization for HF for each patient was 69.5% (60.2–77.4), 16.2% (10–25.2), and 19.3% (11–31.8), respectively (<i>p </i>< 0.001 for both comparisons). In the group telemedicine, the mean number of days hospitalized for HF per patient per year was 8.33 during the year preceding enrollment, 2.3 during the first year of follow-up, and 1.7 during the second. This difference was significant (<i>p </i>< 0.001). The “number of days hospitalized for a heart condition other than HF” was significantly reduced in the group of patient’s beneficiating from the remote monitoring solution. This study demonstrates the value of a protocolized follow-up associated with a therapeutic optimization, therapeutic education program, and the use of a remote monitoring solution to improve the management of ambulatory patients with CHF, particularly of moderate severity. |
topic |
heart failure protocolized follow-up therapeutic education remote monitoring solution telemedicine care pathway |
url |
https://www.mdpi.com/2077-0383/9/10/3106 |
work_keys_str_mv |
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doaj-24ba18c974bf49189173f23ab2970f4e2020-11-25T03:53:45ZengMDPI AGJournal of Clinical Medicine2077-03832020-09-0193106310610.3390/jcm9103106Benefit of Ambulatory Management of Patients with Chronic Heart Failure by Protocolized Follow-Up Therapeutic Education and Remote Monitoring Solution: An Original Study in 159 PatientsAnne Jenneve0Noel Lorenzo-Villalba1Guy Courdier2Samy Talha3François Séverac4Abrar-Ahmad Zulfiqar5Patrick Arnold6Philippe Lang7Gérald Roul8Emmanuel Andrès9Unité de Suivi des Patients Insuffisants Cardiaques, Clinique du Diaconat, 68067 Mulhouse, FranceService de Médecine Interne, Diabète et Maladies Métaboliques, Clinique Médicale B, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, FranceUnité de Suivi des Patients Insuffisants Cardiaques, Clinique du Diaconat, 68067 Mulhouse, FranceEquipe de recherche EA 3072-Mitochondrie, Stress oxydant et Protection musculaire, Faculté de Médecine de Strasbourg, Université de Strasbourg, 67000 Strasbourg, FranceDépartement de Santé Publique/DIM et Biostatistiques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, FranceService de Médecine Interne, Diabète et Maladies Métaboliques, Clinique Médicale B, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, FranceUnité de Suivi des Patients Insuffisants Cardiaques, Clinique du Diaconat, 68067 Mulhouse, FranceUnité de Suivi des Patients Insuffisants Cardiaques, Clinique du Diaconat, 68067 Mulhouse, FranceUnité Fonctionnelle Dédiée à L’insuffisance Cardiaque, Pôle Médical et Chirurgical des Maladies Cardio-vasculaires, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, FranceService de Médecine Interne, Diabète et Maladies Métaboliques, Clinique Médicale B, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, FranceThis study sought to determine whether the implementation of regular and structured follow-up of patients with chronic heart failure (CHF), combined with therapeutic education and remote monitoring solution, leads to better management. This was a single-center retrospective study conducted in a cohort of patients with proven CHF who were followed up in the Mulhouse region (France) between January 2016 and December 2017 by the Unité de Suivi des Patients Insuffisants Cardiaques (USICAR) unit. These patients received regular protocolized follow-up, a therapeutic education program, and several used a telemedicine platform for a two-year period. The primary endpoint was the number of days hospitalized for heart failure (HF) per patient per year. The main secondary endpoints included the number of days hospitalized for a heart condition other than HF and the number of hospital stays for HF per patient. These endpoints were collected during the year preceding enrollment, at one year of follow-up, and at two years of follow-up. The remote monitoring solution was evaluated on the same criterion. Overall, 159 patients with a mean age of 72.9 years were included in this study. They all had CHF, mainly NYHA Class I-II (88.7%), predominantly of ischemic origin (50.9%), and with altered left ventricular ejection fraction in 69.2% of cases. The mean number of days hospitalized for HF per patient per year was 8.33 (6.84–10.13) in the year preceding enrollment, 2.6 (1.51–4.47) at one year of follow-up, and 2.82 at two years of follow-up (1.30–6.11) (<i>p </i>< 0.01 for both comparisons). The mean number of days hospitalized for a heart condition other than HF was 1.73 (1.16–2.6), 1.81 (1.04–3.16), and 1.32 (0.57–3.08), respectively (<i>p </i>= ns). The percentage of hospitalization for HF for each patient was 69.5% (60.2–77.4), 16.2% (10–25.2), and 19.3% (11–31.8), respectively (<i>p </i>< 0.001 for both comparisons). In the group telemedicine, the mean number of days hospitalized for HF per patient per year was 8.33 during the year preceding enrollment, 2.3 during the first year of follow-up, and 1.7 during the second. This difference was significant (<i>p </i>< 0.001). The “number of days hospitalized for a heart condition other than HF” was significantly reduced in the group of patient’s beneficiating from the remote monitoring solution. This study demonstrates the value of a protocolized follow-up associated with a therapeutic optimization, therapeutic education program, and the use of a remote monitoring solution to improve the management of ambulatory patients with CHF, particularly of moderate severity.https://www.mdpi.com/2077-0383/9/10/3106heart failureprotocolized follow-uptherapeutic educationremote monitoring solutiontelemedicinecare pathway |