Page 17 Heart Failure Remote Monitoring Evidence From the Retrospective Evaluation of a Real World Remote Monitoring Program

Discussion

Principal Findings

This study was designed to evaluate the effect of CCCP, a heart failure remote monitoring program with
objective feedback and coaching, compared with matched control patients that received usual care in
the similar clinical settings, on clinical outcomes. Our findings from these retrospective analyses of

medical record data suggest that compared to the control group, CCCP was associated with lower
hospitalization and mortality rates over the 4-month program duration. Although not statistically
significant, the mortality benefit appeared to continue even after following up for an additional 8 months
after program completion (i.e., 1 year from program enrollment) but hospitalizations increased over this

period. We also observed that participants in the program were more likely to have multiple
hospitalizations, but there was no difference in length of hospital stay.
Altogether, these findings suggest that the program was associated with reduction in hospitalization and

mortality rates during the 4-month program duration and kept patients alive who probably would have
died had they not been enrolled in the remote monitoring program. However, the program was
associated with increased rates of hospitalizations and mortality after program completion. We speculate

that the finding of increased hospitalization and mortality after the 4-month program period could be
explained by the progressive nature of the disease, early disproportionate deaths of sicker controls, and
also by the fact that participants had become dependent on being monitored remotely with regular
access to monitoring devices and the telemonitoring nurses. Tapering of the beneficial effect of
monitoring after disenrollment from the program at the end of the 4-month period could also suggest

that patients had not developed sufficient self-competency to manage the disease after leaving the
program. An alternative explanation for higher hospitalization rates could also be that patients had
become sensitized to the early symptoms of disease decompensation due to telemonitoring education

and would present earlier than patients who did not have this education.

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