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Learning to practise differently

This year’s ESC Congress is rich with presentations reporting how remote CV care has been successfully implemented all over the world, often in response to the COVID-19 pandemic.

One of today’s highlights on remote management is a presentation by Doctor Katharina Knoll (German Heart Center of Munich - Munich, Germany) who, together with a team from Germany, investigated the real-life effectiveness of a combined telemonitoring and telecoaching programme for patients with chronic heart failure (HF). The programme consisted of regular individualised telecoaching sessions about disease-related topics (e.g. adherence to medication, nutrition and physical activity) by specially trained tele-nurses as well as daily remote telemonitoring of HF signs and symptoms (e.g. dyspnoea, oedema and weight).

Between January 2018 and September 2020, 6,065 patients with HF at high risk for re-hospitalisation who were members of a statutory health insurance were enrolled in the combined telemonitoring and telecoaching programme. Outcomes were compared retrospectively with a propensity matched usual-care group (n=6,065). After 1 year, patients enrolled in the programme experienced fewer HF hospitalisations (17.9 versus 21.8 per 100 patient years; p<0.001) and all-cause hospitalisations (129.0 versus 133.2; p=0.015) than those in the usual-care group. Furthermore, the duration of hospitalisations was shorter for HF (2.0 versus 2.6 days/year; p<0.001) and for all causes (12.0 versus 13.4 days/year; p<0.001). In addition, the telecoaching and telemonitoring programme was related to a significantly reduced all­cause mortality compared with usual care, with a calculated number needed to treat to prevent one death in 1 year of 19.3.

Visit Science Box 2 this morning to find out more about this analysis and to learn how other novel remote management strategies have been employed to improve outcomes in HF and also in coronary heart disease and atrial fibrillation.

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.