Kotooka Norihiko, Kitakaze Masafumi, Nagashima Kengo, Asaka Machiko, Kinugasa Yoshiharu, Nochioka Kotaro, Mizuno Atsushi, Nagatomo Daisuke, Mine Daigo, Yamada Yoko, Kuratomi Akiko, Okada Norihiro, Fujimatsu Daisuke, Kuwahata So, Toyoda Shigeru, Hirotani Shin-Ichi, Komori Takahiro, Eguchi Kazuo, Kario Kazuomi, Inomata Takayuki, Sugi Kaoru, Yamamoto Kazuhiro, Tsutsui Hiroyuki, Masuyama Tohru, Shimokawa Hiroaki, Momomura Shin-Ichi, Seino Yoshihiko, Sato Yasunori, Inoue Teruo, Node Koichi
Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, Saga, 849-8501, Japan.
Department of Clinical Medicine and Development, National Cerebral and Cardiovascular Center, Suita, Japan.
Heart Vessels. 2018 Aug;33(8):866-876. doi: 10.1007/s00380-018-1133-5. Epub 2018 Feb 15.
Home telemonitoring is becoming more important to home medical care for patients with heart failure. Since there are no data on home telemonitoring for Japanese patients with heart failure, we investigated its effect on cardiovascular outcomes. The HOMES-HF study was the first multicenter, open-label, randomized, controlled trial (RCT) to elucidate the effectiveness of home telemonitoring of physiological data, such as body weight, blood pressure, and pulse rate, for Japanese patients with heart failure (UMIN Clinical Trials Registry 000006839). The primary end-point was a composite of all-cause death or rehospitalization due to worsening heart failure. We analyzed 181 recently hospitalized patients with heart failure who were randomly assigned to a telemonitoring group (n = 90) or a usual care group (n = 91). The mean follow-up period was 15 (range 0-31) months. There was no statistically significant difference in the primary end-point between groups [hazard ratio (HR), 0.95; 95% confidence interval (CI), 0.548-1.648; p = 0.572]. Home telemonitoring for Japanese patients with heart failure was feasible; however, beneficial effects in addition to those of usual care were not demonstrated. Further investigation of more patients with severe heart failure, participation of home medical care providers, and use of a more integrated home telemonitoring system emphasizing communication as well as monitoring of symptoms and physiological data are required.
家庭远程监测对于心力衰竭患者的家庭医疗护理正变得越来越重要。由于尚无关于日本心力衰竭患者家庭远程监测的数据,我们调查了其对心血管结局的影响。HOMES-HF研究是第一项多中心、开放标签、随机对照试验(RCT),旨在阐明对日本心力衰竭患者进行体重、血压和脉搏率等生理数据的家庭远程监测的有效性(UMIN临床试验注册中心000006839)。主要终点是全因死亡或因心力衰竭恶化再次住院的复合终点。我们分析了181例近期因心力衰竭住院的患者,他们被随机分配到远程监测组(n = 90)或常规护理组(n = 91)。平均随访期为15(范围0 - 31)个月。两组之间在主要终点上无统计学显著差异[风险比(HR),0.95;95%置信区间(CI),0.548 - 1.648;p = 0.572]。对日本心力衰竭患者进行家庭远程监测是可行的;然而,除常规护理的益处外,未显示出其他有益效果。需要对更多重度心力衰竭患者进行进一步调查,让家庭医疗护理提供者参与进来,并使用更综合的家庭远程监测系统,该系统强调沟通以及对症状和生理数据的监测。