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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
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Effect of Telemedicine Interventions on Heart Failure Hospitalizations: A Randomized Trial
Edmar G Ribeiro1, Luisa C C Brant2, Lilian C Rezende1
1School of Nursing Universidade Federal de Minas Gerais Belo Horizonte Brazil.
Journal of the American Heart Association
|March 7, 2025
Summary
Telemedicine interventions significantly reduced heart failure rehospitalizations in Brazil. This approach offers a promising strategy to improve patient outcomes in similar settings.
Area of Science:
- Cardiology
- Public Health
- Health Technology
Background:
- Telemedicine interventions (TMIs) show potential in reducing heart failure (HF) hospitalizations and mortality.
- The impact of low literacy and limited technology access on TMI effectiveness in low- and middle-income countries remains unclear.
Purpose of the Study:
- To evaluate if TMIs, in addition to usual care, can decrease HF-related rehospitalizations in patients discharged from hospitals in Brazil.
- To assess the feasibility and impact of a multicomponent TMI in a resource-limited setting.
Main Methods:
- A randomized clinical trial involving 127 HF patients across 6 public hospitals in Brazil.
- The intervention group received usual care plus weekly nurse-led telephone support, teleconsultations, and text message education.
- The control group received usual care. The primary outcome was HF-related rehospitalizations at 180 days.
Main Results:
- Patients receiving TMIs had a 44% reduction in HF-related rehospitalizations compared to usual care (26% vs. 46%, RR=0.56, P<0.02).
- All-cause death or rehospitalizations were also lower in the TMI group (30% vs. 47%, RR=0.63, P=0.04).
- Results were consistent across per-protocol and subgroup analyses, despite lower-than-expected enrollment due to COVID-19.
Conclusions:
- Telemedicine interventions are effective in reducing heart failure-related rehospitalizations in the studied Brazilian population.
- TMIs demonstrate potential for improving clinical outcomes in heart failure patients, even in settings with potential technological and literacy challenges.
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