A randomized trial of home telemonitoring in a typical elderly heart failure population in North West London: results of the Home-HF study

Abstract

Aims: Heart failure chiefly affects the elderly, with frequent emergency admissions. Telemonitoring can identify worsening heart failure but previous randomized trials have enrolled selected patient populations. The Home-HF study examined the impact of home telemonitoring on typical heart failure patients discharged from three acute hospitals in North West London, UK.

Methods and results: Patients hospitalized with heart failure were randomized to telemonitoring or usual specialist care. Primary outcome measures were days alive and out of hospital. Secondary outcome measures were number and duration of heart failure hospitalizations, clinic visits, and quality of life. We recruited 182 patients. There was no difference in the primary outcome measure in the two groups, but there were significantly fewer unplanned hospitalizations for heart failure decompensation, and a reduction in clinic and emergency room visits in the telemonitoring group. There was no statistically significant difference in the mean direct health service costs.

Conclusion: Home telemonitoring in a typical elderly population of heart failure patients produces a similar outcome to 'usual' specialist care, but reduces clinic and emergency room visits and unplanned heart failure rehospitalizations at little additional cost. This method of disease monitoring may allow specialist services to increase the number of patients under their care.

Figure 1

Home telemonitoring equipment.

Figure 2

Consort diagram showing inclusion, allocation, follow-up, and outcome of patients in the HOME-HF Study. Completed includes patients who died but could potentially have been followed-up for that duration.