A supervised telemedical monitoring in the heart failure population in regions of social exclusion is associated with an improvement in 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 regions of social exclusion would improve their functional performance and quality of life (QoL).

Patients and methods: In this prospective, non-controlled study carried out between June and December 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 Analogue 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, one patient died. Simultaneously, an improvement in NYHA scale by median of 1 class (interquartile range 0-1, P <0.001) was identified. A 6% improvement in QoL was found in emotional function measured by CHFQ (P <0.001) while a 7.7% improvement in subjective health status measured by EQVAS (P <0.001). A history of atrial fibrillation (odds ratio [OR] 1.539, 95% confidence interval [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's supervision was associated with an improvement in NYHA class and QoL in the HF population from regions of social exclusion.