Background: Home telemonitoring is a modern and effective disease management model\nthat is able to improve medical care, quality of life, and prognosis of chronically ill patients, and to\nreduce expenditure. The objective of this study was to evaluate the efficacy, costs, and patientsâ��\nand caregiversâ�� acceptance of our model of telemedicine in a high-risk chronic heart failure (CHF)\nolder population. Methods: Patients with high risk/refractory CHF were included. In the case of\nalarm parametersâ�� modifications, a cardiologist decided to inform the emergency department (ED),\nthe patientâ��s General Practioner, or to programme a clinical ambulatory control. Results: Forty-eight\nCHF patients (28 males; 58.3%), with a mean age of 80.4 �± 7.7 years, entered this clinical experience.\nDuring the 20-months follow-up, four patients dropped out from counselling (8.3%), ambulatory\nclinical control within-24 h was planned in 18% of patients, 11% of patients were admitted to an ED,\nand 18% were hospitalized. Thirteen patients (29.5%) died a cardiac death; hospital admissions for\nheart failure decreased during the year after the enrolment when compared to the year before (from 35\nto 12 acute HF hospitalizations/year; p = 0.0001). Moreover, in these HF patients followed, accesses\nto an ED for an acute episode of HF decompensation reduced from 21/year to five/year (p = 0.0001).\nThe economic expenditure, calculated for the year before and after the enrolment, reduced from\n116.856 Euros to 40.065 Euros/year. Conclusions: A telemedicine surveillance in high-risk older\nCHF patients determines a continuous and active contact between patients/caregivers, the Heart\nFailure Clinic, and family physicians, permitting an early evaluation of signs and symptoms of\nacute decompensation
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