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Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/173776
Impact of telemedicine on the clinical outcomes and healthcare costs of patients with chronic heart failure and mid-range or preserved ejection fraction managed in a multidisciplinary chronic heart failure programme: A sub-analysis of the iCOR randomized trial
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Background The efficacy of telemedicine in the management of patients with chronic heart failure and left ventricular ejection fraction ≥40% is poorly understood. The aim of our analysis was to evaluate the efficacy of a telemedicine-based intervention specifically in these patients, as compared to standard of care alone. Methods The Insuficiència Cardiaca Optimització Remota (iCOR) study was a single centre, randomised, controlled trial, designed to evaluate a telemedicine intervention added to an existing hospital/primary care multidisciplinary, integrated programme for chronic heart failure patients. 178 participants were randomised to telemedicine or usual care, and were followed for six months. For the present sub-analysis, only iCOR participants (n = 116) with left ventricular ejection fraction ≥40% were included. The primary study endpoint was the incidence of an acute non-fatal heart failure event, defined as a new episode of worsening of symptoms and signs consistent with acute heart failure requiring intravenous diuretic therapy. The healthcare-related costs in each study group were also evaluated. Results The incidence of the first occurrence of the primary endpoint was significantly lower in the telemedicine arm (22% vs 56%, p<0.001), with a hazard ratio of 0.33 comparing to the usual care arm (95% confidence interval 0.17-0.64). Telemedicine was also associated with lower mean overall chronic heart failure care-related costs compared to usual care (8163¿ vs 4993¿, p=0.001). The results were consistent in both left ventricular ejection fraction of 40-49% and left ventricular ejection fraction ≥50% patients. Conclusions Our results suggest that telemedicine is a promising strategy for the management of chronic heart failure patients with left ventricular ejection fraction ≥40%. These findings should be replicated in larger cohorts.
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JIMÉNEZ MARRERO, Santiago, YUN, Sergi, CAINZOS ACHIRICA, Miguel, ENJUANES, Cristina, GARAY, Alberto, FARRE, Nuria, VERDÚ, Jose m., LINAS, Anna, RUIZ, Pilar, HIDALGO, Encarnación, CALERO, Esther, COMÍN COLET, Josep. Impact of telemedicine on the clinical outcomes and healthcare costs of patients with chronic heart failure and mid-range or preserved ejection fraction managed in a multidisciplinary chronic heart failure programme: A sub-analysis of the iCOR randomized trial. _Journal of Telemedicine and Telecare_. 2020. Vol. 26, núm. 1-2, pàgs. 64-72. [consulta: 29 de gener de 2026]. ISSN: 1357-633X. [Disponible a: https://hdl.handle.net/2445/173776]