The first group uses the InLife Patient Stations in their homes for remote monitoring, and these patients speak with nurses over the phone for their interactive bi-weekly visit. The second group utilizes LifeView Patient Stations for video televisits as well as monitoring, and nurses initiate scheduled, bi-weekly telehealth visits to assess clinical stability, medication compliance and adherence to sodium and fluid restrictions. Patients in both telehealth groups are prompted daily by their Patient Stations to take their blood pressure, heart rate and weight readings. Vital sign results, as well as patients' responses to questions presented to them on the Patient Stations, are sent automatically to the STARTEL server and accessed via LifeView Provider Stations. Telehealth nurses take appropriate actions to address any findings exceeding defined thresholds. Based on the results of daily monitoring and the clinical needs of patients, unscheduled visits may be initiated as well. Heart failure patient education is provided and reinforced as required.
The primary outcome measured is a composite of total all-cause hospitalizations and total mortality at one year. A wide range of secondary measures includes heart failure morbidity and mortality, cardiovascular hospitalization, total inpatient and outpatient costs, patient-reported quality of life, and patient satisfaction. The study is expected to be completed by November 2009.
"With shortages of nurses, family doctors and specialists across Canada, the STARTEL approach offers a way to extend the reach of limited resources while providing proactive care," said Rajda. "American TeleCare solutions are vital to our research efforts as we pursue our ultimate aim: healthier heart failure patients - at home, not in hospital."
Funding for STARTEL has been provided by AstraZeneca Canada Inc., Canada Health Infoway and the New Brunswick Heart and Stroke Foundation.
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