Abstract 15574: TELEmedicine for Monitoring of Patients With Mechanically Assisted Circulatory Support Out of hospital: TELEMACO Project
Introduction: Telemedicine allows patient assessment and monitoring to facilitate healthcare at a distance. LVAD patients are a particular population in whom the outcome depends on adherence to the mechanical regimen, close medical follow-up and acceptance of a life that is far from normal (batteries, driveline, alarms).
Hypothesis: Telemonitoring systems (TS) and network’s psychological support (NPS) could improve quality of life and mental distress in patients with LVAD and their caregivers.
Methods: TS includes electrocardiograms, pulse-oxymeter, body-weight analysis and real-time INR. NPS was performed weekly with the patients and caregivers separately. Quality of life and psychological assessment, including SF-36, SCL-90-R, STAI-Y, BDI-II, was administered to the patients and their caregivers at the beginning, during and at the end of the study. CBI was administered only to the caregiver.
Results: Between May 2015 and May 2016, 12 patients with LVAD and the respective caregivers were enrolled. In 9 cases the implant strategy was bridge to transplant and in 3 cases was destination therapy. The mean time monitoring was 7 months. All patients and their caregivers were adherent to the study protocol, performing daily transmission of medical data and total participation to psychological support. There was no home fatal complications; one patient died in hospital (due to independent cause by the project); 6 patients were successfully transplanted and 5 patients are still on going. Quality of life increased significantly in LVAD patients and caregivers in SF-36. Regarding mental distress as measured on the SCL-90, we observed a clinically significant improvement both in patients (p < .003) and their caregivers (p < .001). Moreover statistically significant improvements were noted in all groups on the STAI-Y and the BDI-II scores. The decrease of the burden perception in caregivers was also clinically significant (p < .002).
Conclusions: In LVAD population, TS and NPS has proved to be safe and effective and allow immediate control by breaking down the distances. Moreover, direct contact with the doctors and psychological support have improved the quality of life and decreased the typical mental distress of these patients and their caregivers.
Author Disclosures: V. Tarzia: None. C. Cavalli: None. L. Bagozzi: None. J. Bejko: None. T. Bottio: None. B. Volpe: None. G. Gerosa: None.
- © 2016 by American Heart Association, Inc.