Association of patient-centred remote monitoring with clinical outcomes in patients with prior hospitalization: the TELESAT PRIOR-HF study.

内容摘要

Patients recently hospitalized for heart failure (HF) face a high risk of readmission and mortality. Remote monitoring programs (RMPs) may offer a scalable, non-invasive strategy to improve outcomes in this vulnerable population. This prespecified sub-analysis of the TELESAT-HF study included HF patients with at least one HF-related hospitalization in the year preceding study entry. Patients enrolled in the RMP and controls were identified from the French national health database. Controls were then weighted to create a group comparable to the RMP group. The primary endpoint was all-cause mortality, while secondary endpoints included HF-related rehospitalizations and cumulative days spent in hospital. Healthcare costs were also explored. After weighting, &#x223c;1258 patients managed with RMP (mean age 73 years, 33% women) and &#x223c;2321 controls were included. Compared with SoC, RMP was associated with a lower risk of all-cause mortality (23.5% vs. 39.6%; HR 0.54, [95%CI 0.47; 0.63]; P < .001), a lower rate of HF-related hospitalizations (rate ratio: 0.85, [95%CI 0.78; 0.94]; P = .002), including fewer admissions via emergency departments (-32%), reduced need of intensive care (-35%), and fewer cumulative days spent in hospital (estimated absolute difference: -1.77, [95%CI -2.81; -0.72] days; P < .001). Mean total healthcare costs did not differ significantly between groups at 6, 12, or 24 months, despite numerically higher costs in the RMP group at later time points. Subgroup analyses showed consistent associations across age, sex, RMP modality, and the number of prior HF hospitalizations. Among patients recently hospitalized for HF, participation in a non-invasive RMP was associated with lower mortality, fewer HF rehospitalizations, less time spent in hospital, and a broadly cost-neutral profile. These findings support the potential role of RMP as part of routine post-discharge HF care.