1. Telemonitoring versus standard care in heart failure: a randomised multicentre trial
- Author
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Galinier, Michel, Roubille, François, Berdagué, Philippe, Brierre, Gilles, Cantie, Philippe, Dary, Patrick, Ferradou, Jean‐Marc, Fondard, Olivier, Labarre, Jean Philippe, Mansourati, Jacques, Picard, François, Ricci, Jean‐Etienne, Salvat, Muriel, Tartière, Lamia, Ruidavets, Jean‐Bernard, Bongard, Vanina, Delval, Cécile, Lancman, Guila, Pasche, Hélène, Ramirez‐Gil, Juan Fernando, Pathak, Atul, Machecourt, Jacques, Valeix, Bernard, Royer, Thierry, Louvard, Yves, Aboyans, Victor, Beard, Thierry, Cheggour, Saïda, Cottin, Yves, Delarche, Nicolas, Eicher, Jean‐Christophe, Faure, Antoine, Gibelin, Pierre, Gosse, Philippe, Inamo, Jocelyn, Lescure‐Ducay, Maryse, Litalien, Jean, Milhau, Sabine, Pouchelon, Elisabeth, Prunier, Fabrice, Salloum, Antoine, Aloun, Jocelyn Souk, Tartière, Jean‐Michel, Taudou, Marie‐José, Thuny, Franck, Tribouilloy, Christophe, Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), MSP Beziers, Centre Hospitalier de Beziers, Centre Hospitalier Intercommunal Castres-Mazamet, Clinique Pasteur [Toulouse], Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), CHU Bordeaux [Bordeaux], Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre Hospitalier Universitaire [Grenoble] (CHU), CHU Toulouse [Toulouse], Air Liquide Santé International, Service de Pharmacologie Clinique, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Hôpital Purpan [Toulouse], CHU Limoges, Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre hospitalier de Pau, Hôpital Pasteur [Nice] (CHU), Hôpital Saint-André, Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Laboratoire de Protection et Remodelage du Myocarde (PMRM), Université d'Angers (UA)-Université d'Angers (UA), Hôpital Sainte-Musse, Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Service de Cardiologie [Amiens], CHU Amiens-Picardie, Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service Pharmacologie Clinique [CHU Toulouse], and Pôle Santé publique et médecine publique [CHU Toulouse]
- Subjects
Male ,Relative risk reduction ,Telemonitoring ,medicine.medical_specialty ,Class iii ,030204 cardiovascular system & hematology ,Rate ratio ,03 medical and health sciences ,0302 clinical medicine ,Primary outcome ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Standard care ,Internal medicine ,Hospitalisation ,medicine ,Humans ,Editorial Comments ,Aged ,Aged, 80 and over ,Heart Failure ,business.industry ,Hazard ratio ,Standard of Care ,Patient education ,Body weight ,Middle Aged ,medicine.disease ,Telemedicine ,Confidence interval ,3. Good health ,Hospitalization ,Heart failure ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Female ,Cardiology and Cardiovascular Medicine ,business ,Editorial Comment - Abstract
International audience; Aims: The aim was to assess the effect of a telemonitoring programme vs. standard care (SC) in preventing all‐cause deaths or unplanned hospitalisations in heart failure (HF) at 18 months.Methods and results: OSICAT was a randomised, multicentre, open‐label French study in 937 patients hospitalised for acute HF ≤12 months before inclusion. Patients were randomised to telemonitoring (daily body weight measurement, daily recording of HF symptoms, and personalised education) (n = 482) or to SC (n = 455). Mean ± standard deviation number of events for the primary outcome was 1.30 ± 1.85 for telemonitoring and 1.46 ± 1.98 for SC [rate ratio 0.97, 95% confidence interval (CI) 0.77–1.23; P = 0.80]. In New York Heart Association (NYHA) class III or IV HF, median time to all‐cause death or first unplanned hospitalisation was 82 days in the telemonitoring group and 67 days in the SC group (P = 0.03). After adjustment for known predictive factors, telemonitoring was associated with a 21% relative risk reduction in first unplanned hospitalisation for HF [hazard ratio (HR) 0.79, 95% CI 0.62–0.99; P = 0.044); the relative risk reduction was 29% in patients with NYHA class III or IV HF (HR 0.71, 95% CI 0.53–0.95; P = 0.02), 38% in socially isolated patients (HR 0.62, 95% CI 0.39–0.98; P = 0.043), and 37% in patients who were ≥70% adherent to body weight measurement (HR 0.63, 95% CI 0.45–0.88; P = 0.006).Conclusion: Telemonitoring did not result in a significantly lower rate of all‐cause deaths or unplanned hospitalisations in HF patients. The pre‐specified subgroup results suggest the telemonitoring approach improves clinical outcomes in selected populations but need further confirmation.
- Published
- 2020