European Journal of Cardiovascular Nursing
11(4) 410–418
© The European Society of Cardiology 2012
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DOI: 10.1016/j.ejcnurse.2011.02.003
cnu.sagepub.com
EUROPEAN
SOCIETY OF
CARDIOLOGY
®
Introduction
Heart failure (HF) has a high prevalence, a poor prognosis
and a high rate of hospital readmission
1,2
. Patient compli-
ance with recommendations regarding lifestyle changes,
Evaluation of a telemedicine system for
heart failure patients: feasibility,
acceptance rate, satisfaction and
changes in patient behavior: results
from the CARME (CAtalan Remote
Management Evaluation) study
Mar Domingo,
1 ,2 ,3
Josep Lupón,
1,4
Beatriz González,
1
Eva Crespo,
1
Raúl López,
1
Anna Ramos,
1
Agustàn Urrutia,
1,4
Guillem Pera,
3
José Ma Verdú
4 ,5
and Antoni Bayes-Genis
1,4
Abstract
Background: Telemedicine can be useful for managing heart failure (HF), but patient acceptance of telemedicine and its
impact on patient behavior are unclear.
Aims: To assess a telemedicine program in a HF Unit.
Methods and results: This sub-analysis of the CARME study assessed the use of an interactive telemedicine platform.
This prospective intervention study had a before/after design with HF patients randomized 1:1 into two groups: A)
Motiva system (educational videos, motivational messages, and questionnaires); and B) Motiva system + telemonitoring
of blood pressure, heart rate and weight. Of 211 patients screened, 44 were excluded, 62 did not consent to participate
and 8 withdrew consent prior to installation of the system. The final study population included 97 patients. During 1 year
of follow-up, 22 patients voluntarily discontinued use of the system, 5 died (three after early discontinuation) and 5 with-
drew consent before the last evaluation. A total of 15,017 questionnaires were sent to patients, with a median response
rate of 88%. Satisfaction with the system and tools was high (median score 8.4/10), especially with the self-monitoring
chart, scale and sphygmomanometer. Positive changes were observed in patient behavior, especially for blood pressure
and weight control (p < 0.001). After the study, 65% of the patients wished to continue with telemonitoring, particularly
those in Group B (p = 0.004).
Conclusion: Less than half of our patients participated in the telemedicine study. However, those who completed the
study had confidence in the system, a high degree of satisfaction with the tools and positive behavioral changes.
Keywords
Heart failure, information and communication technologies, disease management, telemonitoring, telemedicine,
behavior, satisfaction
Received 19 November 2010; revised 8 February 2011; revised manuscript accepted 9 February 2011
3
Unitat de Suport a la Recerca Metropolitana Nord, Institut d’Investigació
en Atenció Primària Jordi Gol, Institut Català de la Salut, Spain
4
Departament de Medicina de la Universitat Autònoma de Barcelona,
Barcelona, Spain
5
Equipo de Atención Primaria Sant Martí de Provençals, Institut Català
de la Salut, Barcelona, Spain
Corresponding author:
Josep Lupón, Unitat d’Insuficiència Cardíaca, Hospital Universitari
Germans Trias i Pujol, Badalona, Barcelona, Spain
Email: jlupon.germanstrias@gencat.cat
37216CNU 11 4 10.1016/j.ejcnurse.2011.02.003Domingo et al.European Journal of Cardiovascular Nursing
Original Article
1
Unitat d’Insuficiència Cardíaca, Hospital Universitari Germans Trias i
Pujol, Badalona, Barcelona, Spain
2
Equipo de Atención Primaria Sant Roc, Institut Català de la Salut,
Badalona, Barcelona, Spain
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