Congestive Heart Failure Home Telemonitoring
Congestive Heart Failure Home Telemonitoring
Remote monitoring of chronic heart failure can reduce deaths and hospitalisations, and may
 provide benefits on health care costs and quality of life. Currently there is limited use of
 remote monitoring for heart failure in Norway. The funding streams and the structure of the
 norwegian health service is different from other countries that have tried remote monitoring
 and therefore it is important to examine the utility of such services in Norway. The study is
 a randomised controlled trial that will allow participants in the intervention group to use a
 wireless weight scale and blood pressure monitor device that will send automatically the
 measurements electronically and securely to the Heart Failure Outpatient Clinic of the
 hospital.
Providing patients with chronic heart failure (CHF) access to remote monitoring, for example
 by telephone or telemonitoring using wireless technology, reduces deaths and hospitalisations
 and may provide benefits on health care costs and quality of life. Remote monitoring of
 patients can reduce pressure on resources, particularly for conditions like chronic heart
 failure, which exert a large burden on health services. These are conclusions of a Cochrane
 Systematic Review.

 In Norway the costs for treatment of chronic heart failure are vast, both concerning hospital
 treatment, daily use of medication over years, and loss of quality of life for patients and
 their family caregivers. Generally there is little knowledge about what is gained for the
 billions used. In Norway no telemonitoring services are established and hence no
 investigations have yet been published. Thus it seems that current evidence of effectiveness
 and quality is insufficient to recommend usage. The structure and funding streams in
 Norwegian health services are different from other countries and the conventional services
 that the intervention has been compared to in previous studies, are most likely
 heterogeneous. It is thus important to investigate Norwegian conditions.

 Advanced telemonitoring technology with electronic transfer of physiological data such as
 blood pressure and weight is currently being used in research and established routine
 services in several countries in Europe, amongst them the Netherlands, Germany and the United
 Kingdom.

 The proposed project intends to introduce such a strategy as an avenue for exploring
 promising new services that would not otherwise be available in Norway. The service consists
 of daily monitoring the patients' weight and blood pressure directly from their home;
 automatically and securely transmit the values to a server at UNN; and monitor the values by
 a trained nurse at the Heart polyclinic.

 The primary objective of this study is thus to explore whether, as compared to current care
 from the heart polyclinic, the introduction of home telemonitoring will reduce hospital
 readmissions and will, in addition, be cost-effective. This is in line with the recent
 directions of European telemonitoring programmes for patients with chronic heart failure.
 This result may define if the telemonitoring of heart failure patients is feasible for Norway
 or not at all.

 Identifying successful innovations to be introduced into the Norwegian health care services
 is a condition for more cost effectiveness and better treatment quality.
Inclusion Criteria:

 -  the presence of CHF signs and symptoms such as dyspnoea and peripheral or pulmonary
 oedema requiring diuretic administration (New York Heart Association [NYHA] functional
 class II-IV); and

 -  ejection fraction (EF) under 40% combined or not with a left ventricular filling
 pattern supporting the presence of diastolic dysfunction, according to the American
 College of Cardiology/American Heart Association Guidelines for chronic heart failure.

 Exclusion Criteria:

 -