Disease management with home telemonitoring aimed at substitution of usual care in the Netherlands: Post-hoc analyses of the e-Vita HF study

J Cardiol. 2022 Jan;79(1):1-5. doi: 10.1016/j.jjcc.2021.08.003. Epub 2021 Aug 26.

Abstract

Background: Home telemonitoring in heart failure (HF) patients may reduce workload of HF nurses by reducing face-to-face contacts. The aim of this study is to assess whether telemonitoring as a substitution could have negative effects as expressed by less reduction in circulating natriuretic peptide levels between baseline and one-year of follow up compared to usual care.

Methods: A post-hoc analysis of the e-Vita HF trial, a three-arm parallel randomized trial conducted in stable HF patients. Patients were randomized into three arms: (i) usual HF outpatient care, (ii) usual care combined with the use of the website heartfailurematters.org, and (iii) telemonitoring (e-Vita HF platform) instead of face-to-face consultations. Mixed linear model analyses were applied to assess differences in the N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels between the three arms over a year.

Results: A total of 223 participants could be included (mean age 67.1 ± 10.1 years, 27% women, New York Heart Association class I-IV; 39%, 38%, 14%, and 9%). The mean left ventricular ejection fraction was 35 ± 10%. The median of routine face-to-face contacts over a year was 1.0 lower (2.0 vs. 3.0) in the third arm compared with usual care. Median NT-proBNP levels did not significantly differ between the three arms.

Conclusion: In stable and optimally treated HF patients, telemonitoring causing a reduction of routine face-to-face contacts seems not to negatively affect hemodynamic status as measured by NT-proBNP levels over time.

Keywords: B-type natriuretic peptides; Heart failure; Home telemonitoring; N-terminal prohormone of brain natriuretic peptide.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers
  • Disease Management
  • Female
  • Heart Failure* / therapy
  • Humans
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain
  • Netherlands
  • Peptide Fragments
  • Stroke Volume
  • Telemedicine*
  • Ventricular Function, Left*

Substances

  • Biomarkers
  • Peptide Fragments
  • Natriuretic Peptide, Brain