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ISSN: 1734-1922
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ESC Congress Simultaneous Publications
abstract:

Quality of life in heart failure patients undergoing hybrid comprehensive telerehabilitation versus usual care – results of the Telerehabilitation in Heart Failure Patients (TELEREH-HF) Randomized Clinical Trial

Ewa Piotrowicz
1
,
Anna Mierzyńska
2
,
Maciej Banach
3
,
Izabela Jaworska
4, 5
,
Michał Pencina
6
,
Ilona Kowalik
7
,
Sławomir Pluta
8
,
Dominika Szalewska
9
,
Grzegorz Opolski
10
,
Wojciech Zaręba
11
,
Renata Glowczynska
10
,
Robert Irzmański
12
,
Piotr Orzechowski
1
,
Zbigniew Kalarus
8
,
Ryszard Piotrowicz
2, 13

1.
Telecardiology Center, National Institute of Cardiology, Warsaw, Poland
2.
Department of Coronary Artery Disease and Cardiac Rehabilitation, National Institute of Cardiology, Warsaw, Poland
3.
Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
4.
Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice; Silesian Centre for Heart Diseases, Zabrze, Poland
5.
Palliative Medicine Department, St. Camillus Hospital, Tarnowskie Gory, Poland
6.
Duke University’s School of Medicine, Durham, United States of America
7.
National Institute of Cardiology, Warsaw, Poland
8.
Silesian Center for Heart Disease. Zabrze, Poland
9.
Department of Rehabilitation Medicine, Medical University of Gdansk, Gdansk, Poland
10.
1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
11.
University of Rochester Medical Center, Rochester, NY, United States of America
12.
Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Lodz, Lodz, Poland
13.
Warsaw Academy of Medicine Rehabilitation, Warsaw, Poland
Arch Med Sci
Online publish date: 2020/08/21
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Introduction
Hybrid comprehensive telerehabilitation (HCTR) consisting of telecare (with psychological telesupport), telerehabilitation and remote monitoring of implantable devices might be an innovative option improving heart failure (HF) patients’ quality of life (QoL) and emotional health. The aim of the study was to investigate the influence of HCTR on various facets of QoL in HF patients in comparison with usual care (UC) alone.

Material and methods
The present analysis formed part of a multicenter, randomized trial that enrolled 850 HF patients (NYHA I–III, LVEF ≤ 40%). Patients were randomized 1 : 1 to HCTR plus UC or UC only. Patients underwent either an HCTR program or UC with observation. The psychological intervention in the HCTR group included supportive psychological counseling via mobile phone. The Medical Outcome Survey Short Form 36 Questionnaire was used to assess QoL. Measurements were made before and after a 9-week intervention (HCTR group)/observation (UC group).

Results
After the intervention, the HCTR group showed significant improvement in overall QoL, physical domain (PD) of QoL, and 4 areas of QoL (physical functioning (PhF), role functioning related to physical state (RF), general health (GH), vitality (VI)). A significant positive change in QoL in the UC group was observed only in VI and social functioning. There were also significant differences in QoL after 9-week intervention/observation between the two groups. The results showed greater improvement in HCTR for overall QoL (p = 0.009), PD of QoL (p = 0.0003) and three specific areas of QoL: PhF (p = 0.001), RF (p = 0.003), bodily pain (BP) (p = 0.015).

Conclusions
In comparison to UC, HCTR resulted in improvement in overall QoL, PD of QoL and 3 specific areas of QoL: PhF, RF and BP.

keywords:

quality of life, hybrid telerehabilitation, heart failure, telemanagement

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