TY  - GEN
A1  - Völler, Heinz
A1  - Bindl, Dominik
A1  - Nagels, Klaus
A1  - Hofmann, Reiner
A1  - Vettorazzi, Eik
A1  - Wegscheider, Karl
A1  - Fleck, Eckart
A1  - Nagel, Eckhard
T1  - Remote telemonitoring in chronic heart failure does not reduce healthcare cost but improves quality of life
T2  - Journal of the American College of Cardiology
N2  - Background: Evidence that home telemonitoring (HTM) for patients with chronic heart failure (CHF) offers clinical benefit over usual care is controversial as is evidence of a health economic advantage. Therefore the CardioBBEAT trial was designed to prospectively assess the health economic impact of a dedicated home monitoring system for patients with CHF based on actual costs directly obtained from patients’ health care providers.

Methods: Between January 2010 and June 2013, 621 patients (mean age 63,0 ± 11,5 years, 88 % male) with a confirmed diagnosis of CHF (LVEF ≤ 40 %) were enrolled and randomly assigned to two study groups comprising usual care with and without an interactive bi-directional HTM (Motiva®). The primary endpoint was the Incremental Cost-Effectiveness Ratio (ICER) established by the groups’ difference in total cost and in the combined clinical endpoint “days alive and not in hospital nor inpatient care per potential days in study” within the follow up of 12 months. Secondary outcome measures were total mortality and health related quality of life (SF-36, WHO-5 and KCCQ).

Results: In the intention-to-treat analysis, total mortality (HR 0.81; 95% CI 0.45 – 1.45) and days alive and not in hospital (343.3 ± 55.4 vs. 347.2 ± 43.9; p = 0.909) were not significantly different between HTM and usual care. While the resulting primary endpoint ICER was not positive (-181.9; 95% CI −1626.2 ± 1628.9), quality of life assessed by SF-36, WHO-5 and KCCQ as a secondary endpoint was significantly higher in the HTW group at 6 and 12 months of follow-up.

Conclusions: The first simultaneous assessment of clinical and economic outcome of HTM in patients with CHF did not demonstrate superior incremental cost effectiveness compared to usual care. On the other hand, quality of life was improved. It remains open whether the tested HTM solution represents a useful innovative approach in the recent health care setting.
Y1  - 2017
UR  - https://publishup.uni-potsdam.de/frontdoor/index/index/docId/55197
SN  - 0735-1097
SN  - 1558-3597
VL  - 69
IS  - 11 Supplement
SP  - 672
EP  - 672
PB  - Elsevier
CY  - New York
ER  -