Jesus Olmos Montes (Spain)
Hospital Universitario Virgen Macarena Internal MedicineAuthor of 1 Presentation
ANALYSIS OF THE FUNCTIONAL CAPACITY OF PATIENTS WITH ADVANCED CARDIAC AND/OR RESPIRATORY DISEASE INCLUDED IN A CLINICAL TRIAL OF TELEMONITORING OF CONSTANTS. ATLAN_TIC PROJECT.
Abstract
Background and Aims
To analyze the functional capacity of patients with advanced cardiac and/or respiratory disease included in a clinical trial of telemonitoring of constants.
Methods
Multicenter clinical trial including patients with heart failure with NYHA≥III and/or chronic respiratory failure with MRC≥III and/or oxygen saturation<90% and/or oxygen therapy.Randomization in PAC Arm (optimal standard of clinical care) and TELEPAC Arm (addition of constant telemonitoring equipment) to evaluate the requirements of hospitalization and emergency visits. Follow-up of 180 days. Secondary analysis of functional capacity using Barthel's index.
Results
510 patients from 5 hospitals were included, 255 patients in each arm. Median age was 76,5 years, being 54.5% females. Cardiac inclusion criteria were presented for 321 patients (63.1%), respiratory 71(13.9%) and 117(22.9%) both criteria.The 67.6% had multimorbility. Median score of the Charlson index of 2 points, PALIAR index of 0 points (predicting 21% mortality at 6 months) and PROFUND index of 6 points (predicting 20% mortality at one year).The analysis of functional capacity showed no initial differences (PAC 72.09+/-22.46, TELEPAC 74.6+/-22.85,p=0.32). At the end of the study, a decrease in the Barthel index was observed in the PAC arm and an increase in the TELEPAC arm (PAC 70.93+/-24.986,TELEPAC 75.41+/-24.871,p >0.05).Quality of life using the Euroqol thermometer showed an increase throughout the study with differences in favor of the TELEPAC arm (mean PAC of 56.38±21.62,TELEPAC 64.09±19.91,p < 0.01).
Conclusions
Telemonitoring in the ATLAN_TIC project meant an statistically significant increase in functional capacity, but with little clinical magnitude. Specific studies in this area are necessary.