Evaluation of the AUTONOM@DOM Telemonitoring System for People With Heart Failure

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

84 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-04-30

Study Completion Date

2017-06-30

Brief Summary

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Heart failure is the principle cause of hospitalisation for people over 65. the assumption is that a system of home based telemonitoring can reduce the rate of unscheduled hospitalisation or rehospitalisation for heart failure (compared to a care package alone), This randomised controlled pilot study should assess the feasibility in terms of patient inclusion and follow-up.

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Detailed Description

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Chronic diseases such as heart failure are a major burden for healthcare systems They are punctuated by exacerbations, often markers of poor prognosis, and are associated with expensive unscheduled hospitalizations. After initial diagnosis, despite the development of both drug and physical therapies, the rate of re-hospitalization for heart failure remains high with 50% or more of patients readmitted within 6 months.

Recommendations for the treatment of heart failure patients are extremely precise and justify close collaboration between local community services and the hospital. However there is often considerable divergence between recommended care and the reality, due in particular to the difficulty in monitoring ambulatory patients. For example, the dose titration of beta-blockers or ACE inhibitors need to be monitored, and dosages of diuretics need to be adapted to avoid side effects which affect the quality of life of patients and limit medication adherence etc. The establishment of 'ambulatory' care networks (including multidisciplinary health professionnals of city and hospital and therapeutic patient education) such as that in Isère County in France has demonstrated its effectiveness.

However, more advanced tools for patient monitoring still need to be assessed, particularly 'home monitoring', because there is not yet consensus as to the role tele-monitoring should play in the context of heart failure, and to date recommendations are vague. Assess the clinical and medico-economic benefit of an innovative patient monitoring strategy 'AUTONOM @ DOM' is needed.

The primary aim of this study is then to assess a system of home based telemonitoring .The main outcome is unscheduled hospitalisation for heart failure. secondary aims were to assess the efficacy of this system, quality of life and medico-economic benefit.

This pilot study is realised in the Isère and Essonne counties of France. Patients diagnosed with heart failure will be randomized to one of the following groups:

* conventional care including at least a patient education program (ETICS program in Essone county and RESIC38 network in Isere county);
* conventional care, plus home telemonitoring including a recording of the heart rate, blood pressure and weight, remotely transmitted to the cardiologist by an approved validated system that includes an alert monitoring feature.

The study will last one year starting in April 2014.

Conditions

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Heart Failure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Telemonitoring

Home-based patient management using AUTONOM@DOM telemonitoring system to record and transmit heart rate, blood pressure and weight; along side conventional care (patient therapeutic education or personalised care program)

Group Type EXPERIMENTAL

Telemonitoring

Intervention Type OTHER

Conventional care

Intervention Type OTHER

Conventional care

Conventional care including patient therapeutic education or personalised care program

Group Type ACTIVE_COMPARATOR

Conventional care

Intervention Type OTHER

Interventions

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Telemonitoring

Intervention Type OTHER

Conventional care

Intervention Type OTHER

Other Intervention Names

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Patient therapeutic education: ETICS HPGM or Personalized care program: RESIC 38

Eligibility Criteria

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Inclusion Criteria

* Age 60 years or more
* Covered by French social security system or equivalent
* Written informed consent signed by patient
* Heart failure diagnosed by a cardiologue
* NYHA stage II, III or IV
* Able to be followed-up for 1 year
* Attend general healthcare education sessions

Exclusion Criteria

* Freedom restricted by judicial order
* Under legal protection
* Require peritoneal dialysis or hemofiltration
* Participation refused by patient, primary care physician or cardiologist
* Present a severe comorbidity with poor short-term prognosis
* Present asymptomatic heart failure NYHA stage I
* Programmed surgical intervention: valve prosthesis or revascularization
* Impossibility to follow a program of patient education
* Residing in medicalized care facility for persons without autonomy
* Residing outside the recruitment zones

Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No