The effectiveness of remote monitoring of elderly patients after hospitalisation for heart failure: The renewing health European project ☆ Zoran Olivari a, ⁎ ,1 , Sara Giacomelli a,1 , Lorenzo Gubian b,1 , Silvia Mancin c,1 , Elisa Visentin c,1 , Vincenzo Di Francesco d,1 , Sabino Iliceto e,1 , Michelangelo Penzo f,1 , Albino Zanocco g,1 , Carlo Marcon h,1 , Maurizio Anselmi i,1 , Domenico Marchese j,1 , Panagiotis Stafylas k,1 a Dipartimento Cardiovascolare, Ospedale Cà Foncello, Piazzale Ospedale, 1, Treviso, Italy b Veneto Region Health Information System, Via Pacinotti, 4, Marghera, Venezia, Italy c Arsenàl.IT, Veneto's Research Centre for eHealth Innovation, viale Oberdan, 5, Treviso, Italy d U.O.C. Geriatria A, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale A. Stefani, 1,Verona, Italy e Clinica Cardiologica e Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari Università degli Studi di Padova, via Giustiniani, 2, Padova, Italy f UOC Cardiologia UTIC, Ospedale SS. Giovanni e Paolo, Castello, 6777 Venezia, Italy g Dipartimento di Cardiologia e Medicina dello Sport, Ospedale di Mirano, via Don Giacobbe Sartor, 4, Mirano, Venezia, Italy h U.O. Cardiologia, Ospedale S. Maria dei Battuti, via Brigata Bisagno, 4,Conegliano, Treviso, Italy i U.O.C. Cardiologia, Ospedale G. Fracastoro, San Bonifacio, via Circonvallazione, 1, Verona, Italy j U.O.C. Cardiologia, Ospedale di Piove di Sacco, via San Rocco, 8, Piove di Sacco, Padova, Italy k Health Information Management SA, Boulevard Lambermont, 84, Brussels, Belgium article info Article history: Received 29 May 2017 Received in revised form 30 August 2017 Accepted 26 October 2017 1. Introduction The prevalence of heart failure (HF) in Western countries is in the range of 1–2% in the adult population, rising to N 10% among persons aged 80 or more [1] and it has a major impact on mortality, quality of life, hospital admissions, and cost of care, particularly in elderly patients [1–3]. In the Veneto Region, Italy, HF is the second leading cause of hospital admissions (4.7/1.000 inhabitants in 2009) [4]. In most patients HF is a chronic condition that requires frequent clinical input and treatment adjustments to improve outcomes and reduce the need for hospitalisation. Several attempts to improve the care transition process after hospital discharge, with the involvement of cardiologists, internists, general practitioners, nurses – alongside with patients' and caregivers empowerment - have been carried out with favourable results [5–8]. In this scenario, telehealth technologies by telephone contacts and/or remote monitoring (RM), may be effective in the early detection of impending clinical conditions worsening, leading to prompt management and eventually improving the outcome and avoiding hospital readmissions. Unfortunately, the effectiveness of RM in the management of heart failure is still unclear [9]: some metanalyses suggest clinical benefits [10–12] not confirmed in others [13] and the same is true for the results of randomized clinical trials, some demonstrating the utility of RM [14] but not confirmed in others [15–18] or applicable to some subgroups of patients only [19]. The reasons for these discordances are complex and likely due to variability in patient selection, the specific RM methodologies used and the differ- ences in the interventions provided to patients in the usual care groups. The most recent ESC Guidelines for the diagnosis and treatment of HF suggest that this approach needs to be assessed on the individual basis [20]. This study was part of the European RENEWING HEALTH project, and we aimed to explore the effectiveness of remote monitoring in elderly patients with heart failure, in Italy and Greece, early after hospital discharge. As the study aborted in Greece due to administrative reasons, in this manuscript we report the data regarding patients enrolled in Italy. The study was registered at clinicaltrials.gov (NCT01513993). 2. Methods The RENEWING HEALTH project, part of the European Competitive- ness Innovation Framework Programme ICT Policy Support Programme (CIP ICT PSP), was carried out between October 2011 and May 2014 in 9 European regions. The project aimed to validate - in real life settings and with rigorous assessment methodology - the use of telemedicine systems for the remote monitoring of patients with chronic disease, such as chronic obstructive pulmonary disease or diabetes mellitus, older people with multiple morbidities, patients with implantable defibrillators and those with chronic heart failure. International Journal of Cardiology 257 (2018) 137–142 ☆ Trial Registration: clinicaltrials.gov NCT01513993. ⁎ Corresponding author. E-mail address: zoran.olivari@gmail.com (Z. Olivari). 1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation. https://doi.org/10.1016/j.ijcard.2017.10.099 0167-5273/© 2017 Elsevier B.V. All rights reserved. Contents lists available at ScienceDirect International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard