No favourable effect on mortality was observed with STS HM .
Similar reductions were observed in all-cause hospitalisations for TM interventions , whereas STS interventions had no major effect .
STS HM was dominated by usual care .
Similar results were observed in scenario analyses performed using higher costs of usual care , higher costs of STS HH and lower costs of TM during office hours .
As a result , the economic model developed scenarios for different RM classifications and their costs were estimated using bottom-up costing methods .
Despite wide variation in usual care and RM strategies , cost-effectiveness analyses suggest that TM during office hours was an optimal strategy ( in most costing scenarios ) .
However , clarity was lacking among descriptions of the components of RM packages and usual care and there was a lack of robust estimation of costs .
BACKGROUND Remote monitoring ( RM ) strategies have the potential to deliver specialised care and management to patients with heart failure ( HF ) .
OBJECTIVE To determine the clinical effectiveness and cost-effectiveness of home telemonitoring ( TM ) or structured telephone support ( STS ) strategies compared with usual care for adult patients who have been recently discharged ( within 28 days ) from acute care after a recent exacerbation of HF .
The review included r and omised controlled trials ( RCTs ) or observational cohort studies with a contemporaneous control group that included the following RM interventions : ( 1 ) TM ( including cardiovascular implanted monitoring devices ) with medical support provided during office hours or 24/7 ; ( 2 ) STS programmes delivered by human-to-human contact ( HH ) or human-to-machine interface ( HM ) .
Impact of the nursing consultation on the frequency of hospitalizations in patients with heart failure in Curitiba, Parana State.
BACKGROUND Heart failure ( HF ) has become a public health problem with increased incidence and prevalence in the last decade , a consequence of the aging of the population and improved pharmacological and interventionist therapies . It has high rates of mortality and morbidity , expressed as high rates of hospitalizations and re-hospitalizations , even in patients su bmi tted to new therapies , especially ACEI and beta-blockers . OBJECTIVE This study is the analysis of the impact that the nursing consultation has on the frequency of hospitalizations in patients with HF living in the city of Curitiba , state of Parana and its metropolitan region . METHOD Patients with a diagnosis of HF and New York Heart Association ( NYHA ) functional classification , with telephone access , living in the city of Curitiba or its metropolitan region , life expectancy > 3 months due to non-cardiac diseases , aged 18 or older , non-users of illicit drugs . The groups were created by simple r and om allocation ( drawing lots ) and one group received the usual medical care , nursing consultation and telephone monitoring every 15 days of educational nature , intervention group ( IG ) , whereas the other group received the usual medical care , monthly telephone monitoring of administrative and epidemiological nature , control group ( CG ) . The follow-up was carried out for 6 months . RESULTS The IG needed 0.25+/-0.79 and the CG needed 1.10 + /-1.41 ; p = 0.037 hospitalizations . CONCLUSION The nursing consultation promotes the decrease in the frequency of hospitalizations in patients with HF undergoing treatment and living in the city of Curitiba and its metropolitan region
No favourable effect on mortality was observed with STS HM .
Similar reductions were observed in all-cause hospitalisations for TM interventions , whereas STS interventions had no major effect .
STS HM was dominated by usual care .
Similar results were observed in scenario analyses performed using higher costs of usual care , higher costs of STS HH and lower costs of TM during office hours .
As a result , the economic model developed scenarios for different RM classifications and their costs were estimated using bottom-up costing methods .
Despite wide variation in usual care and RM strategies , cost-effectiveness analyses suggest that TM during office hours was an optimal strategy ( in most costing scenarios ) .
However , clarity was lacking among descriptions of the components of RM packages and usual care and there was a lack of robust estimation of costs .
BACKGROUND Remote monitoring ( RM ) strategies have the potential to deliver specialised care and management to patients with heart failure ( HF ) .
OBJECTIVE To determine the clinical effectiveness and cost-effectiveness of home telemonitoring ( TM ) or structured telephone support ( STS ) strategies compared with usual care for adult patients who have been recently discharged ( within 28 days ) from acute care after a recent exacerbation of HF .
The review included r and omised controlled trials ( RCTs ) or observational cohort studies with a contemporaneous control group that included the following RM interventions : ( 1 ) TM ( including cardiovascular implanted monitoring devices ) with medical support provided during office hours or 24/7 ; ( 2 ) STS programmes delivered by human-to-human contact ( HH ) or human-to-machine interface ( HM ) .