Clinical and Psycological Telemonitoring and Telecare of High Risk Patientswith Chronic Heart Failure through Wireless Technologies: The Icaros Project
|Alessandra Villani1, Gabriella Malfatto1, Francesco Della Rosa1, Valeria Rella1, Tommaso Comotti1, Giovanna Branzi1, Angelo Compare2, Lara Bellardita3, Enrico Molinari4, Gianfranco Parati1,5*|
|1Divisione di Cardiologia, Ospedale San Luca, Istituto Auxologico Italiano IRCCS, Milano, Italy|
|2Dipartimento di Psicologia, Università degli studi di Brescia, Italy|
|3Istituto Nazionale dei Tumori IRCCS, Milano, Italy|
|4Dipartimento di Psicologia, Università Cattolica del Sacro Cuore, Milano, Italy|
|5Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università di Milano-Bicocca, Milano, Italy|
|Corresponding Author :||Gianfranco Parati
Divisione di Cardiologia, Ospedale San Luca
Istituto Auxologico Italiano IRCCS, Piazzale
Brescia and Dipartimento di Medicina Clinica
Prevenzione e Biotecnologie Sanitarie
Università di Milano, Bicocca, Milano, Italy
E-mail: [email protected]
|Received May 24, 2013; Accepted July 04, 2013; Published July 06, 2013|
|Citation: Villani A, Malfatto G, Rosa FD, Rella V, Comotti T, et al. (2013) Clinical and Psycological Telemonitoring and Telecare of High Risk Patients with Chronic Heart Failure through Wireless Technologies: The Icaros Project. J Clin Exp Cardiolog 4:260. doi: 10.4172/2155-9880.1000260|
|Copyright: © 2013 Villani A, 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.|
|Related article at
Pubmed Scholar Google
Background: Disease management is mandatory for the home care of most patients with chronic heart failure. We report the results of ICAROS (Integrated care vs Conventional intervention in cArdiac failure patients: Randomized Open label Study), an Italian trial of telemonitoring and telecare combining wireless and mobile technologies to obtain optimal therapeutic control, fast and effective interpretation of clinical data and improved patients’ adherence.
Methods: Eighty patients were randomized before hospital discharge after an episode of acute heart failure, to a usual care group (UC) (n=40: follow-up at our Outpatients’ clinic) or to an integrated management group (IM) (n=40: patients learned to use a PDA computer and kept in touch daily with our Centre to receive instructions, encouragement, clinical and psychological assistance. Results: At enrolment, groups were similar for age (UC 73 ± 3 years; IM 71 ± 2 years); NYHA class (UC 2.90 ± 0.69; IM 3.08 ± 0.57), left ventricular function (EF%) (UC 32 ± 8%; IM 32 ± 7%), plasma levels of BNP (UC 361 ± 72 pg/ml; IM 314 ± 94 pg/ml). At one-year follow-up, IM patients showed better adherence, reduction of anxiety and depression and lower NYHA class and plasma levels of BNP with respect to UC patients (NYHA: 2.08 ± 0.38; BNP: 202 ± 127 pg/ml, p<0.05 vs UC patients). Mortality and hospital re-admissions for congestive heart failure were also reduced in IM patients (p<0.05).
Conclusions: In ICAROS, regular acquisition by wireless technologies of clinical and psychological data provided a good model for clinical decision-making, determining better quality of life and reducing mortality and hospitalizations.