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Methods Inf Med 2015; 54(05): 388-397
DOI: 10.3414/ME15-02-0002
Original Articles
Schattauer GmbH

Evaluation of an Integrated Telemonitoring Surveillance System in Patients with Coronary Heart Disease

E. Ammenwerth
1   Institute of Biomedical Informatics, UMIT – University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
,
S. Woess
1   Institute of Biomedical Informatics, UMIT – University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
,
C. Baumgartner
2   Institute of Electrical and Biomedical Engineering, UMIT – University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, and Institute of Health Care Engineering with European Notified Body of Medical Devices, Graz University of Technology, Graz, Austra
,
B. Fetz
3   Clinical Division of Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria
,
A. van der Heidt
3   Clinical Division of Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria
,
P. Kastner
4   Digital Safety and Security Department, AIT Austrian Institute of Technology, Vienna, Austria
,
R. Modre-Osprian
4   Digital Safety and Security Department, AIT Austrian Institute of Technology, Vienna, Austria
,
S. Welte
4   Digital Safety and Security Department, AIT Austrian Institute of Technology, Vienna, Austria
,
G. Poelzl
3   Clinical Division of Cardiology and Angiology, Medical University of Innsbruck, Innsbruck, Austria
› Author Affiliations
Further Information

Publication History

received: 02 February 2015

accepted: 06 July 2015

Publication Date:
22 January 2018 (online)

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Summary

Objectives: Cardiovascular diseases are the most frequent cause of death in industrialized countries. Non-adherence with prescribed medication and recommended lifestyle changes significantly increases the risk of major cardiovascular events. The telemonitoring programme MyCor (Myokardinfarkt und Koronarstent Programm in Tirol) is a multi-modal intervention programme to improve lifestyle and medication management of patients with coronary heart disease (CHD). It includes patient education, self-monitoring with goal-setting and feedback, and regular clinical visits. We evaluated the MyCor telemonitoring programme regarding technical feasibility, user acceptance, patient adherence, change in health status, and change in quality of life.

Methods: A 4½-month study was conducted with two telemonitoring phases and one interim phase. The study comprised patient surveys, standardized assessment of quality of life using the MacNew questionnaire at study entry and after 4 and 18 weeks, analysis of adherence to medication and physical activity during the two telemonitoring phases, and analysis of reached goals regarding health conditions during the telemonitoring phases.

Results: Twenty-five patients (mean age: 63 years) participated in the study. Patients showed a high acceptance of the MyCor tele-monitoring programme. Patients reported feelings of self-control, motivation for lifestyle changes, and improved quality of life. Adherence to daily measurements was high with 86% and 77% in the two telemonitoring phases. Adherence to medication was also high with up to 87% and 80%. Pre-defined goals for physical activity were reached in up to 86% and 73% of days, respectively. Quality of life improved from 5.5 at study entry to 6.3 at the end (p< 0.01; MacNew questionnaire). Reductions in blood pressure and heart rate or an improvement in reaching defined goals could not be observed.

Conclusions: The MyCor telemonitoring programme Tirol for CHD patients has a high rate of acceptance among included patients. Critical evaluation revealed subjective benefits regarding quality of life and health status as well as high adherence rates to medication and lifestyle changes. Achieving long-term adherence and verifying clinical outcomes, however, remains an open issue. Our findings will promote further studies, addressing different strategies for an optimal mix of patient education, telemonitoring, feedback, and clinical follow-ups.

Keywords

Medical informatics - evaluation studies - cardiovascular diseases - myocardial infarction - blood pressure monitoring - patient empowerment - medication adherence
 

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