176-75: Telemonitoring – A successful approach to provide sustainable care for patients with chronic heart failure in rural Rhineland-Palatinate, Germany

Abstract

Background: Adverse demographic changes in the German population such as an increasing prevalence of chronic diseases combined with the decreasing number of health care providers, especially in rural areas, call for innovative approaches to provide sustainability of care. We implemented a regional telemonitoring program for patients with chronicheart failure (CHF) with the aim to improve patient's symptoms and study their acceptance. Method: 100 elderly CHF patients (EF , 35%, NYHA II-IV)living in rural Rhineland-Palatinate with a mean age of 63,82 years, and on optimized medication were included. Patients were equipped with home monitoring systems which daily sent data on their blood pressure, heart rate, and weight to thetelemonitoring-centre. 24/7 Service was provided by a regional hospital in cooperation with a nationwidetelemonitoring-provider. Action was taken whenever data exceeded a range that was individually defined for each patient. Additionally, patients received weekly (later monthly)semi-standardised telephone calls from special trained heart failure nurses, and could call the telemonitoring-centre as needed. Results: The Telemonitoring program supervised 91 patients (7 drop outs due to death, 2 drop out due to rapid onset of dementia). Although elderly, 98% found the handling of the gadgets easy or very easy and would recommend the approach to their family or friends. Educative elements of the program strengthened their self-sufficiency, 35% reported a more confident self-management of the CHF. Improvement is documented in the table (p , 0,01; 5 pointLikert-scale: 1 = extreme severe symptom/ extremely affected by the CHF, 5 = symptom is not present/ not affected by the CHF) (Table Presented). Conclusion: Although Telemonitoring is a new approach it is well accepted by elderly patients. Results suggest, that Telemonitoring can considerably reduce symptoms of elderly patients with CHF and improve their wellbeing. Moreover, Telemonitoring empowers the patients and positively influences their mental health.