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

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 withdrew 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.