Cited by 716Telemedicine and Telehealth ImplementationHeart Failure Treatment and ManagementMobile Health and mHealth Applications

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Impact of Remote Telemedical Management on Mortality and Hospitalizations in Ambulatory Patients With Chronic Heart Failure: The Telemedical Interventional Monitoring in Heart Failure Study

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Koehler, Friedrich, Winkler, Sebastian, Schieber, Michael, Sechtem, Udo, Stangl, Karl, Böhm, Michael, Boll, Herbert, Baumann, Gert, Honold, Marcus, Koehler, Kerstin, Gelbrich, Goetz, Kirwan, Bridget-Anne, Anker, Stefan D.·2011·Circulation

DOI 10.1161/circulationaha.111.018473

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Abstract

Background—: This study was designed to determine whether physician-led remote telemedical management (RTM) compared with usual care would result in reduced mortality in ambulatory patients with chronic heart failure (HF). Methods and Results—: We enrolled 710 stable chronic HF patients in New York Heart Association functional class II or III with a left ventricular ejection fraction ≤35% and a history of HF decompensation within the previous 2 years or with a left ventricular ejection fraction ≤25%. Patients were randomly assigned (1:1) to RTM or usual care. Remote telemedical management used portable devices for ECG, blood pressure, and body weight measurements connected to a personal digital assistant that sent automated encrypted transmission via cell phones to the telemedical centers. The primary end point was death from any cause. The first secondary end point was a composite of cardiovascular death and hospitalization for HF. Baseline characteristics were similar between the RTM (n=354) and control (n=356) groups. Of the patients assigned to RTM, 287 (81%) were at least 70% compliant with daily data transfers and no break for >30 days (except during hospitalizations). The median follow-up was 26 months (minimum 12), and was 99.9% complete. Compared with usual care, RTM had no significant effect on all-cause mortality (hazard ratio, 0.97; 95% confidence interval, 0.67 to 1.41; P =0.87) or on cardiovascular death or HF hospitalization (hazard ratio, 0.89; 95% confidence interval, 0.67 to 1.19; P =0.44). Conclusions—: In ambulatory patients with chronic HF, RTM compared with usual care was not associated with a reduction in all-cause mortality. Clinical Trial Registration:—: URL: http://www.ClinicalTrials.gov . Unique identifier: NCT00543881.

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Authors: Koehler, F., Winkler, S., Schieber, M., Sechtem, U., Stangl, K., Böhm, M., Boll, H., Baumann, G., Honold, M., Koehler, K., Gelbrich, G., Kirwan, B.-A., & Anker, S. D.
Affiliations: Robert Bosch Hospital (DE)
ORCID: Koehler, Friedrich
Winkler, Sebastian
Sechtem, Udo
Stangl, Karl
Böhm, Michael
Kirwan, Bridget-Anne
Anker, Stefan D.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2011-05-03
Volume: 123
Issue: 17
Pages: 1873-1880
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/circulationaha.111.018473
OpenAlex: W2152527332
Cited by: 716
References: 14
Citations by year: 2026: 25 · 2025: 29 · 2024: 34 · 2023: 37 · 2022: 57 · 2021: 62 · 2020: 43 · 2019: 35 · 2018: 51 · 2017: 68 · 2016: 48 · 2015: 57 · 2014: 45 · 2013: 43 · 2012: 57
FWCI: 53.11
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
University of Bedfordshire Repository (University of Bedfordshire) (submittedVersion)
Funders: Bundesministerium für Wirtschaft und Technologie
Deutsches Zentrum für Luft- und Raumfahrt
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords: chronic heart failure, outpatients, all-cause mortality, cardiovascular mortality, heart failure hospitalization, remote monitoring, telemedicine, left ventricular ejection fraction
MeSH terms: Aged, Ambulatory Care, Blood Pressure, Body Weight, Electrocardiography, Female, Follow-Up Studies, Heart Failure, Hospitalization, Humans, Male, Managed Care Programs, Middle Aged, Quality of Life, Outcome Assessment, Health Care, Telemedicine, Computers, Handheld

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Impact of Remote Telemedical Management on Mortality and Hospitalizations in Ambulatory Patients With Chronic Heart Failure: The Telemedical Interventional Monitoring in Heart Failure Study

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