Telemedicine to Monitor Elderly Patients with Chronic Diseases, with a
Special Focus on Patients with Chronic Heart Failure
Emmanuel Andrès
1,2*
, Samy Talha
3
, Mohamed Hajjam
4
, Jawad Hajjam
5
, Sylvie Ervé
5
and Amir Hajjam
6
1
Service de Médecine Interne, Diabète et Maladies métaboliques de la Clinique Médicale B, CHRU de Strasbourg, Strasbourg, France
2
Centre de Recherche Pédagogique en Sciences de la Santé, Faculté de Médecine de Strasbourg, Université de Strasbourg (UdS), Strasbourg, France
3
Service de Physiologie et d’Explorations fonctionnelles, CHRU et Faculté de Médecine de Strasbourg, Université de Strasbourg (UdS), Strasbourg, France
4
Engineering and IT company, Newel, Mulhouse, France
5
Centre d'Expertise des TIC pour l'autonomie (CenTich) et Mutualité Française Anjou-Mayenne (MFAM), Angers, France
6
Laboratoire IRTES-SeT, Université de Technologie de Belfort-Montbéliard (UTBM), Belfort-Montbéliard, France
*
Corresponding author: Emmanuel Andrès, Service de Médecine Interne, Diabète et Maladies métaboliques de la Clinique Médicale B, CHRU de Strasbourg,
Strasbourg, France, Tel: 33388116768; E-mail: emmanuel.andres@chru-strasbourg.fr
Rec Date: May 13, 2016, Acc Date: Jun 01, 2016, Pub Date: Jun 03, 2016
Copyright: © 2016 Andrès E, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and source are credited
Abstract
Chronic diseases are one of the most difficult challenges to the beginning of the twentieth century. Monitoring
patients with chronic diseases, especially in chronic heart failure or diabetes mellitus, using telemedicine systems is
a potential means for optimizing the management of these patients, even in elderly patients. The e-care project is
developing an “intelligent” communicative platform enabling the home monitoring of patients with heart failure, using
non-invasive sensors, with additional contextual information and patients’ profile. As a result, this platform will assist
health care professionals by providing an automated processing of these sensors’ transmitted data in order to detect
and report signs of cardiac decompensation early or wrong adherence to therapy.
Keywords: Telemedicine; Chronic disease; Elderly patients; Heart
failure; Detecting signs of cardiac decompensation
Chronic Diseases
One of the greatest challenges that will face health care professionals
to the beginning of the twentieth century will be the increasing burden
of chronic diseases. Greater longevity, modifcation of lifestyles and
exposure to chronic disease risk factors (e.g. inactivity, tobacco, too
rich and greasy food…), and the growing ability to intervene to keep
people alive that previously would have died has combined to change
the burden of diseases confronting health systems [1]. Chronic diseases
can have a profound impact on the health and quality of life of
elderlies, not to mention the fnancial burden that is ofen associated
with long-term illness.
Tese chronic diseases or disorders are defned by the World Health
Organization (WHO) as requiring “ongoing management over a
period of years or decades” and cover a wide range of health problems
[2]. In Europe, the OMS provides an “epidemic” of chronic diseases in
the next 20 years. Te four main expected chronic diseases are: heart
failure (HF), chronic obstructive pulmonary disease (COPD),
cognitive disorders (as Alzheimer’s disease) and cancers. Other
disorders may also be observed in the future as diabetes mellitus,
obesity, hypertension, renal failure and anemia. Four chronic diseases:
heart disease, cancer, stroke, and diabetes currently cause almost two-
thirds of all deaths each year in the United States. About 80% of older
adults have at least one chronic disease, and 68% have at least two.
Increased life expectancy generates changes in the leading causes of
morbidity and mortality with more than 70% attributable to chronic
diseases [3]. More than 15 million patients today contract such
diseases and the expected fgure amounts to 20 million by 2020.
Telemedicine
To our experience, these conditions require a complex response,
taken into account several conditions in the same patients, over an
extended time period that involves coordinated inputs from a wide
range of health professionals and access to essential medicines and
monitoring systems, all of which need to be optimally embedded
within a system that promotes patient empowerment and home
support.
In response to the emerging challenge posed by chronic diseases,
several countries have experimented with new models of healthcare
delivery that can achieve better coordination of services across the
continuum of care [1,3]. Telemedicine may ofer a promising system in
such patients with chronic diseases, especially in frailty or too good
condition patients [3]. Tis is particularly the case in chronic
conditions in which early detection of impairment and/or
complication may be detected.
A lot of the sickness, disability and even death associated with
chronic disease can be avoided through preventive measures and
telemedicine and telemonitoring. Moreover when an older person is
diagnosed with a chronic condition, there is an immediate feeling of
facing a loss of freedom and autonomy, a sense that his or her days of
living independently at home are numbered. Telemedicine system
ofers the possibility of a high patient quality of life at home.
Nevertheless, the results of telemonitoring studies and meta-
analyses have been controversial. In reviews assessing these methods,
telemedicine approaches range from computer-based support systems
Andrès, et al., J Gerontol Geriatr Res 2016, 5:3
DOI: 10.4172/2167-7182.1000311
Review Article Open Access
J Gerontol Geriatr Res
ISSN:2167-7182 JGGR, an open access journal
Volume 5 • Issue 3 • 1000311
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ISSN: 2167-7182
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Gerontology & Geriatric Research