Supervised telemedical monitoring in the heart failure population in the regions of social exclusion is associated with improved functional capacity and quality of life

Abstract

INTRODUCTION Telemedicine is intended to provide medical care to patients in remote areas. OBJECTIVES This study sought to investigate whether the application of e‑health solutions for patients with heart failure (HF) who live in the regions of social exclusion would improve their functional perfor‑ mance and quality of life (QoL). PATIENTS AND METHODS In this prospective, noncontrolled study carried out between June and Decem‑ ber 2023, HF patients were enrolled in 14 primary care units located in 5 rural voivodeships in eastern Poland. All patients were evaluated at baseline and after 3 months using the New York Heart Association (NYHA) scale, Chronic Heart Failure Questionnaire (CHFQ), and EuroQol Visual Analog Scale (EQVAS), and monitored by a general practitioner under the supervision of a cardiologist. RESULTS In 429 patients with HF, more than 100 000 telemedical examinations / consultations were performed resulting in 575 treatment modifications. During the 3‑month program, 1 patient died. Simul‑ taneously, an improvement in the NYHA scale by a median of 1 class (interquartile range, 0–1; P <0.001) was identified. A 6% improvement in QoL was found in the emotional function measured by the CHFQ (P <0.001), and a 7.7% improvement was observed in subjective health status measured by the EQVAS (P <0.001). A history of atrial fibrillation (odds ratio [OR], 1.539; 95% CI, 1.021–2.353) and no history of cancer (OR, 2.793; 95% CI, 1.224–6.369) were associated with the NYHA class improvement. CONCLUSIONS The applied telemedical model of care under the specialist supervision was associated with an improvement in the NYHA class and QoL in the HF population from the regions of social exclusion.