Effects of remote patient management on self-care behaviour in heart failure patients: results from the randomized TIM-HF2 trial.

Aims: Remote patient management (RPM) in heart failure (HF) patients has beneficial clinical effects. This analysis investigates the effects of RPM used in the Telemedical Interventional Management in Heart Failure II (TIM-HF2) trial on HF-specific self-care.
Methods and Results: From 2013 to 2017, 1538 HF outpatients (age 70.3 ± 10.5 years, 70% men, 52%/47% NYHA II/III, 65% LVEF ≤45%) with a recent HF hospitalization were included to the study and randomized to usual care (UC) plus RPM (n = 796) or UC only (n = 775), with a 12-month follow-up. Self-reported self-care behaviour at baseline and at end of study was assessed with the 9-item European Heart Failure Self-care Behaviour Scale (EHFScBS-9), obtaining 1321 patients with valid baseline and follow-up questionnaires for the analysis. EHFScBS-9 sum scores increased in the RPM group (n = 667) from 78.7 ± 17 to 84.5 ± 14 and in the UC group (n = 654) from 79.0 ± 17 to 80.0 ± 16 from baseline to 12 months [difference in means (MD) 4.58 (3.02, 6.14); P < 0.001] with highest improvement [8.66 (3.52; 13.81)] in patients living alone and having an inadequate (<70) baseline EHFScBS-9. There were differences between both groups in item 'I weight myself every day' [MD -1.13 (-1.24, -1.02); P < 0.001] and item 'I take my medication as prescribed' [MD -0.06 (-0.10, -0.01); P = 0.014]. No correlation was found between the EHFScBS-9 score and the efficacy of RPM on the TIM-HF2 primary endpoint of percentage of days lost due to unplanned cardiovascular hospitalization or death of any cause.
Conclusions: RPM improves HF-specific self-care behaviour by achieving a better adherence to recommended HF regimen.
Registration: ClinicalTrials.gov: NCT01878630.
Competing Interests: Conflicts of interest: F.K. has received fees for presentation from AMGEN GmbH, Sanofi-Aventis Deutschland GmbH, Abbott Medical GmbH, AstraZeneca, BIOTRONIK, Boehringer Ingelheim, and Novartis; Scientific Grants from German Federal Ministry of Science and Education (BMBF), German Federal Ministry of Economics and Climate Protection (BMWK), and advisory boards from Sanofi-Aventis Deutschland GmbH, BIOTRONIK. S.W. has received fees for lectures from AstraZeneca, Novartis, Bayer Vital GmbH, and advisory boards from BIOTRONIK. All other authors have nothing to declare.
(© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)