Phone telemonitoring after heart-failure flare
Home mobile-phone telemonitoring after acute heart-failure decompensation cut primary events and hospital days versus usual care.
Source
Effect of home-based telemonitoring using mobile phone technology on the outcome of heart failure patients after an episode of acute decompensation: randomized controlled trial
Study at a glance
- Design
- RCT — MOBITEL multicentre RCT; home telemonitoring via mobile phones vs control
- N
- N=120 · Stopped early at 120 of a planned 240 (eight centres; median age 66); many patients could not operate the phone
- Population
- Adults after acute heart-failure decompensation
- Outcome
- Cardiovascular death or HF re-hospitalisation over 6 months
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Phone telemonitoring after heart-failure flare
These passages occur verbatim in the stored paper text. They support the points listed below; they do not verify every statement in the explanation.
ITT primary events 17% tele vs 33% control (RRR 50%).
Intention-to-treat analysis indicated that 18 control group patients (33%) reached the primary endpoint (1 death, 17 hospitalizations) compared with 11 tele group patients (17%, 0 deaths, 11 hospitalizations; relative risk reduction 50%, 95% CI 3-74%, P = .06; a).
120 patients were randomized.
Overall, 120 patients (85 male, 35 female) with a median age of 66 years (IQR 62-72) were randomized in eight centers: 54 patients were randomized to the control group (39 m
What they did
MOBITEL randomized 120 patients after acute decompensation to home telemonitoring via mobile phones versus control across eight centres, following primary death/HF hospitalization endpoints for 6 months.
What they found
ITT primary events 17% tele vs 33% control (RRR 50%, P=.06); per-protocol RRR 54% (P=.04); NYHA improved only in tele group; HF hospital stays shorter (median 6.5 vs 10 days).
The limits
What it doesn't show
Whether modern smartphones change effect sizes, and some patients were “never beginners” unable to use equipment.
Key terms
- Telemonitoring
- Remote transmission of patient physiologic/symptom data for clinical oversight.
- Acute decompensation
- Worsening heart failure prompting acute care before enrolment.
- NYHA class
- Functional class of heart-failure symptom limitation.
- Intention-to-treat (ITT)
- Analyze as randomized, including non-starters.
- Per-protocol analysis
- Analyze participants who followed assigned monitoring as intended.
- Relative risk reduction
- Proportional decrease in event risk in intervention vs control.
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Quiz yourself
ITT primary events were roughly:
Common questions
What was the ITT primary-event contrast?
17% tele vs 33% control (RRR 50%, P=.06).
Did per-protocol results strengthen?
Yes—15% events in tele group, RRR 54%, P=.04.
Did symptoms improve?
Median NYHA improved 3→2 only in the tele group.
Hospital length of stay?
Shorter in tele patients hospitalized for worsening HF (6.5 vs 10 days).
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