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European Journal of Heart Failure Advance Access published online on January 27, 2009
European Journal of Heart Failure, doi:10.1093/eurjhf/hfn050
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

A randomized trial of home telemonitoring in a typical elderly heart failure population in North West London: results of the Home-HF study

Owais Dar1,2, Jillian Riley1,2, Callum Chapman3, Simon W. Dubrey4, Stephen Morris5, Stuart D. Rosen1,6, Michael Roughton2 and Martin R. Cowie1,2,*

1 National Heart & Lung Institute, Imperial College, Dovehouse Street, London SW3 6LY, UK
2 Royal Brompton and Harefield NHS Trust, London, UK
3 West Middlesex Hospital NHS Trust, Middlesex, UK
4 Hillingdon Hospital NHS Trust, Middlesex, UK
5 Health Economic Research Group, Brunel University, Middlesex, UK
6 Ealing Hospital NHS Trust, London, UK

* Corresponding author. Tel: +44 207 351 8856, Fax: +44 207 351 8148, Email: m.cowie{at}imperial.ac.uk


  Abstract

Aims: Heart failure chiefly affects the elderly, with frequent emergency admissions. Telemonitoring can identify worsening heart failure but previous randomized trials have enrolled selected patient populations. The Home-HF study examined the impact of home telemonitoring on typical heart failure patients discharged from three acute hospitals in North West London, UK.

Methods and results: Patients hospitalized with heart failure were randomized to telemonitoring or usual specialist care. Primary outcome measures were days alive and out of hospital. Secondary outcome measures were number and duration of heart failure hospitalizations, clinic visits, and quality of life. We recruited 182 patients. There was no difference in the primary outcome measure in the two groups, but there were significantly fewer unplanned hospitalizations for heart failure decompensation, and a reduction in clinic and emergency room visits in the telemonitoring group. There was no statistically significant difference in the mean direct health service costs.

Conclusion: Home telemonitoring in a typical elderly population of heart failure patients produces a similar outcome to ‘usual’ specialist care, but reduces clinic and emergency room visits and unplanned heart failure rehospitalizations at little additional cost. This method of disease monitoring may allow specialist services to increase the number of patients under their care.

Key Words: Heart failure • Telemonitoring • Disease management

Received November 3, 2008; Accepted December 11, 2008


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