This is the first time that a telehealth system combining remote patient monitoring with motivational educational support tools has been researched, and the results demonstrate significant additional value and effectiveness for managing the health of chronically ill heart failure patients. Previous studies have analyzed the advantages of telehealth in terms of patient care, decrease in hospital admissions and cost savings, such as TEN-HMS ("Noninvasive Home Telemonitoring for Patients With Heart Failure at High Risk of Recurrent Admission and Death", Journal of American College of Cardiology, May 17, 2005, Volume 45, No. 10). The CARME study now demonstrates the additional benefit for patients of including remote educational and motivational tools to improve their quality of life.
The study monitored 92 patients with severe heart failure at home, managed by the Hospital Germans Trias i Pujol Heart Failure Clinic. The interactive telehealth system Philips Motiva was used to connect patients to their health care providers via their home television and a broadband internet connection. Patients can take vital measurements in their homes and communicate the information to their physician via the system, and they can also receive educational and motivational information from their physician to help manage their health.
The final data from the CARME study show a significant clinical benefit in using Philips Motiva to monitor heart failure patients in the home, by comparing clinical outcomes 12 months prior to enrollment with the results obtained during the observation period. Results of the study showed a decrease of 68 percent in heart failure related hospitalizations and a reduction of days spent in hospital by 73 percent.
CARME also reveals that patients showed a continuous and significant improvement in their perception of quality of life over the 12 month observation period, an improvement that ranged from 62 percent to 72 percent - depending on the methodology used to measure it (questionnaires "Minnessota Living with Heart Failure" and EuroQoL respectively).
A post-analysis of the results - not presented at the Congress - shows that, at the beginning of the study, more than half of the patients (56 percent) said that their quality of life was "medium" or "low"; this number decreased to 22 percent at the end. Also, the number of patients that considered their quality of life to be "medium-high" rose from 44 percent at the beginning of the study to 78 percent after one year, and more than one-quarter of respondents (28 percent) considered quality of life to be "almost excellent".
In addition, satisfaction with the telemonitoring system was high, specially in those patients who had vital measurements added to their educational and motivational tools. Up to 81 percent of these patients wanted to keep the solution in addition to their regular care.
The patients in the CARME study were randomly assigned to two groups: in one group, the patients received care plan-driven educational videos, motivational messages and questionnaires. The second group received the same information but was also requested to monitor their blood pressure, pulse rate and weight.
"The concept of providing educational support to heart failure patients via their television has significantly contributed to empowering them. Equally important, the CARME study has shown that disseminating patient and disease specific information via the TV, through Philips Motiva, helps family members to gain a better understanding of how to effectively support their loved ones in coping with their disease. This appears to have a very strong impact on outcomes", stated Dr. Josep Lupon, head of the Heart Failure Unit and main researcher of the study.
Walter van Kuijen, general manager Home Monitoring for Philips Home Healthcare Solutions, stated: "It is a great result to see clinically validated proof on the value of telehealth. At Philips, we aim to simplify health care for patients and caregivers with meaningful solutions, and we continue to innovate in areas such as telehealth, which can help health care providers around the globe to better manage the growing population of patients with chronic disease."
As part of the European Union-funded MyHeart research project, Philips and partners are developing an advanced heart-failure management system that could provide more comprehensive information about a patient's condition and may enable earlier intervention. This experimental heart failure management system consists, among others, of a wearable textile vest with an embedded innovative sensor designed to asses the accumulation of fluid in the lungs, the latter being a potentially life-threatening condition heart-failure patients have a serious risk suffering from. In addition, the European Union-funded HeartCycle project headed by Philips explores comprehensive patient-centric solutions based on innovative sensors for chronic disease management at home.
Royal Philips Electronics of the Netherlands is a diversified health and well-being company, focused on improving people's lives through timely innovations. As a world expert in health care, lifestyle and lighting, Philips integrates technologies and design into people-centric solutions, based on fundamental customer insights and the brand promise of "sense and simplicity". Headquartered in The Netherlands, Philips employs more than 116.000 employees in more than 60 countries worldwide. With sales of 23 billion euro in 2009, the company is a market specialist in cardiac care, acute care and home health care, energy efficient lighting solutions and new lighting applications, as well as lifestyle products for personal well-being and pleasure with strong leadership positions in flat TV, male shaving and grooming, portable entertainment and oral health care.
More information is available at the CARME Study with Motiva: Home Healthcare solutions for Heart Failure patients. More news on the HeartCycle project can be found in the VMW March 2008 article Philips led HeartCycle project targets improvement of disease management and quality of life for heart patients.