American College Of Cardiology continued...
[Clinician Reviews 8(6):179--186, 1998. © 1998 Clinicians Publishing Group and Williams & Wilkins.]

Home Heart Failure Monitoring A Promising Option Two medical centers experimenting with home monitoring programs for patients with heart failure have produced evidence that these are safe, cost-effective, and beneficial to patients. The principle of both programs is to communicate changes in clinical status through frequent telephone contact. "The results of our study suggest that it is possible to develop a program that improves the patient's quality of life by keeping him or her out of the hospital while, at the same time, reducing the overall cost of care," reported Paul A. Heidenreich, MD, Stanford (Calif) University Medical Center. In the Stanford program and another developed at the University of Illinois, Chicago, a daily telephone call to report vital statistics, particularly changes in weight, provides the core of the monitoring system. Weight gain is a relatively accurate marker for fluid accumulation and the need for increased diuretics or another management change. At both centers, specific changes in vital statistics are designed to trigger new interventions to prevent hospitalization. Both reported success. "A change in protocol was initiated when weight increased by 2 to 4 pounds. This reduced hospitalization rates by 90% during 6 months of follow-up. We were also able to show an improvement in quality of life relative to baseline," reported Mary Bondmass, RN, regarding the Chicago program. Tested on 64 patients in two different protocols, the Chicago telemanagement service features automatic recording and transmission of the patient's weight and vital signs, Ms. Bondmass explained. At Stanford, hospitalizations were cut in half over a 12-month period when 43 patients in the program were compared with 86 heart failure patients who were not enrolled and had a similar clinical status. Patients in the active treatment program generated an average of only $7,400 in insurance claims versus $19,000 among those not enrolled. The benefits were attributed to reduced deterioration among program participants. "If we can get information to the [clinician] immediately, they have time to make changes in medication or provide other necessary care," Dr. Heidenreich explained. continued...		Section 9 of 10 CONTENTS Introduction Why Fewer Blacks Have CABG Surgery Stenting Enhances Post-MI PTCA Are Stents Worthwhile After 80? New Settings For Angioplasty Implanted Device May Outperform Antiarrhythmic Drugs Targeting Angry Patients For Cardiac Rehab Amiodarone Reduces Risk Of Atrial Fibrillation After Bypass Home Heart Failure Monitoring A Promising Option Poor Patients Pay More For Medications INTERACT Printable version of this article. Email this article to a colleague. RECOMMENDED LINKS Our editor's recommendations for related articles, web pages, patient information, and similar resources are located here.

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