Newcard telemonitoring system improves survival in comparison with other French telemonitoring systems in chronic heart failure as assessed by data extract from the French National Health Data System

Abstract

Introduction

In the NEWTS3 Program, we have shown an effect on global mortality for heart failure (HF) patients using NEWCARD telemonitoring system (NewTM) versus traditional approach. It was associated with an increase in hospitalizations but with less trips to the emergency room.

Objective

One aim of the NEWTS3EXT study is to extend this comparison to patients followed by other telemonitoring French systems (TLM) selected in the SNDS (French National Health Data System).

Method

All NewTM patients monitored at least 3 months between 2017 and 2020 were included. For each patient, anonymised data was retrieved from the SNDS. TLM group was randomly selected from an extraction of SNDS of patients with CHF including a reimbursement of telemonitoring but not followed by Newcard. This TLM group was matched in a 1:1 ratio to NewTM patients using a propensity score including baseline characteristics, presence of comorbidities and presence of significative treatments. Binomial negative GEE models were used on matched data sets to assess differences.

Results

919 NewTM patients were matched to 919 TLM patients. We show an increase statically significative in survival rates in the NewTM group versus TLM group at 48 months (OR 0.832 P = 0.0394) (Fig. 1). Despite no global difference in hospitalisation rate, there's a trend to a decrease statically significative in the NewTM group versus TLM group at 12 and 24 months. At the level of the emergency room, no differences between groups.

Conclusion

NEWTS3EXT Study is one of the first comparison between one specific solution and a group of others. Explaining the positive result on all-cause mortality for the NewTM must be a mix of plenty of specificities especially in a complex process like telemonitoring of HF. To help to find the best place for telemonitoring in the care pathway of HF, we can emphasize on the high level of adherence of the NewTM patients (data collected every 1.4 days) and on the precise process to ensure that every alert is followed by a medical response.