Telemedical care: feasibility and perception of the patients and physicians: a survey-based acceptance analysis of the Telemedical Interventional Monitoring in Heart Failure (TIM-HF) trial

Abstract

Background: The randomized Telemedical Interventional Monitoring in Heart Failure (TIM-HF) trial (NCT00543881) was performed during 2008 and 2010 to determine whether physician-led remote patient management (RPM) compared with usual care would result in reduced mortality and morbidity in stable out-patient heart failure (HF) patients. However, besides results of clinical benefit, the acceptance by patients and primary physicians is necessary for the implementation of RPM as part of the upcoming out-patient HF-care programs.

Methods: Two months after finishing of the trial, a survey based analysis of the perception of telemedical care with patients (n=288) and primary physicians (n=102) was carried out. The survey included questions regarding self-management, usability and physician-patient communication.

Results: The concept of RPM was perceived positively by patients and physicians. The devices were assessed as easy to use (98.6%, n=224) and robust (88.8%, n=202). Through trial participation and daily measurements most of the patients (85.5%, n=195) felt more confident in dealing with their disease than before. The perception of the nurses and physicians of the telemedical centers was professional (92.1%, n=210 and 89.9%, n=205) and committed (94.3%, n=215 and 91.7%, n=209). Also more than half of the patients noticed an improvement in the contact with their primary physician (52.6%, n=120); and for 46.1% (n=105) the contact has not been changed.

Conclusions: RPM will be a medical care concept for recently hospitalized HF- patients in the near future but the optimal telemedical setting of RPM and the duration of this intervention have to be defined in further clinical trials.

Keywords: Chronic heart failure; TIM-HF trial; hospitalisation; perception; remote patient management; telemedicine.