Standard Physician Care for Heart Failure is Just as Effective as and Less Expensive Than a Home Monitoring System
April 1, 2008 By Alexandra M. Palmer 
ACC 08-Chicago, IL: The Heart Failure Home Care (HFHC) trial demonstrates that heart failure (HF) patients receiving standard follow-up care from a physician have just as good of a clinical result and a better economic outcome than those using a home-monitoring interactive system. Results were presented today by Dr. Ozlem Z. Soran at the American College of Cardiology 2008 Scientific Sessions.
The goal of the Heart Failure Home Care (HFHC) trial was to evaluate the effect of the computer-based telephonic Alere DayLink HF Monitoring System (ADLHFM) on the clinical and economic outcomes of Medicare patients recently treated for HF at a community hospital. Endpoints consisted of cardiovascular death or re-hospitalization for HF, length of hospital stay, total patient cost and cost to medicare at 6 months of enrollment.
The HFHC trial was a multicenter, controlled trial that enrolled 315 medicare-eligible patients ≥65 years of age who had been hospitalized for HF within 6 months of randomization and who demonstrated persistent symptoms in response to treatment. 160 patients were randomized to ADLHFM and 155 to standard heart failure care (SC). Follow-up time was 6-months.
Comparison of the 6-month endpoints demonstrated no significant difference between the two forms of treatment. Standard patient care was just as effective as a home monitoring device in improving the clinical outcomes of HF.
In the 6-month cost-analysis, the mean total societal costs were higher for ADLHFM ($20,190 vs. $15,966). Likewise, the cost to Medicare was more for the monitoring system ($17,837 vs. $13,886).
The investigators conclude that as long as patients are knowledgeable about their condition and receive follow-up physician care, there is no need for a home monitoring device.
This trial was sponsored by Centers for Medicare and Medicaid Services, Baltimore, Maryland
- Ozlem Z. Soran, Judith R. Lave, Ileana L. Piña, Gervasio A. Lamas, Sheryl F. Kelsey, Faith Selzer, John Pilotte, Arthur M. Feldman. Societal Cost and Cost to Medicare for Enhanced Monitoring Using a Computer-Based Telephonic Monitoring System in Older Patients With Heart Failure: The Heart Failure Home Care Trial.
- Late Breaking Clinical Trials Session: ACC Annual Scientific Sessions, April 1, 2008 Chicago