Background: New strategies are required to optimize care in increasing numbers of chronic heart failure patients. The aim of this randomised trial was to evaluate a remote guidance system. Methods: Intervention group patients received a home TV-channel providing educational materials. Tele-guidance was performed by a Medical Service Centre. Control group patients were followed by cardiologists and HF-nurses. Primary endpoints were total days in hospital for all causes and days alive and out of hospital. Secondary endpoints were: quality of life and knowledge of disease and self care. Results: 214 patients were enrolled, median age was 66 years, 89% had systolic LV dysfunction, and 90% were in NYHA class II or III. The mean LVEF was 31%. Over a mean follow-up duration of 288 days, there were 199 hospital admissions in 105 patients. Comparison of the groups revealed no differences for the primary outcomes or for QoL or self care behaviour. Knowledge about heart failure however, increased significantly more in the Intervention group (p < 0.001). Conclusion: Tele-guidance may play a role in the management of heart failure patients since it takes over some of the tasks of HF-nurses. This may facilitate delivery of optimal care to more patients with the same level of experienced staff.

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European Journal of Heart Failure
Erasmus MC: University Medical Center Rotterdam

Balk, A., Davidse, W., Dommelen, P., Klaassen, E., Caliskan, K., van der Burgh, P., & Leenders, C. M. (2008). Tele-guidance of chronic heart failure patients enhances knowledge about the disease. A multi-centre, randomised controlled study. European Journal of Heart Failure, 10(11), 1136–1142. doi:10.1016/j.ejheart.2008.08.003