Page 1 Heart Failure Remote Monitoring Evidence From the Retrospective Evaluation of a Real World Remote Monitoring Program

Heart Failure Remote Monitoring: Evidence From the Retrospective Evaluation

of a Real-World Remote Monitoring Program

ABSTRACT

Background: Given the magnitude of increasing heart failure mortality, multidisciplinary approaches, in
the form of disease management programs and other integrative models of care, are recommended to
optimize treatment outcomes. Remote monitoring, either as structured telephone support or

telemonitoring or a combination of both, is fast becoming an integral part of many disease management
programs. However, studies reporting on the evaluation of real-world heart failure remote monitoring
programs are scarce.

Objective: This study aims to evaluate the effect of a heart failure telemonitoring program, Connected
Cardiac Care Program (CCCP), on hospitalization and mortality in a retrospective database review of
medical records of patients with heart failure receiving care at the Massachusetts General Hospital.
Methods: Patients enrolled in the CCCP heart failure monitoring program at the Massachusetts General
Hospital were matched 1:1 with usual care patients. Control patients received care from similar clinical

settings as CCCP patients and were identified from a large clinical data registry. The primary endpoint
was all-cause mortality and hospitalizations assessed during the 4-month program duration. Secondary
outcomes included hospitalization and mortality rates (obtained by following up on patients over an

additional 8 months after program completion for a total duration of 1 year), risk for multiple
hospitalizations and length of stay. The Cox proportional hazard model, stratified on the matched pairs,
was used to assess primary outcomes.
Results: A total of 348 patients were included in the time-to-event analyses. The baseline rates of
hospitalizations prior to program enrollment did not differ significantly by group. Compared with

controls, hospitalization rates decreased within the first 30 days of program enrollment: hazard ratio
(HR) =0.52, 95% CI 0.31-0.86, P=.01). The differential effect on hospitalization rates remained

pg. 1