Telemonitoring-supported and specialized home carfe in advanced heart failure

Purpose and aims: We aim to design a study of specialized home care in advanced/end-stage heart failure (HF) providing telemonitoring and personnel trained in Cardiology.

The overall aim is to provide a safe and cost-effective alternative to the present routine care of repeated unplanned hospitalizations.State of knowledge: Telemedicine is increasingly incorporated into clinical routine and its advantages in HF are gradually acknowledged.

Half of hospitalizations in advanced HF occur during the last 2 months prior to death at a state when acute treatment is limited to palliative measures.

Such therapy could ideally be provided in home care but require HF nurses to overcome insecurities reported by caregivers lacking experience.

The use of telemonitoring and specialized HF support represents an attractive alternative that has not been tested scientifically.Planning and preliminary study: The planning will use existing study data from electronic health records and telemonitoring to develop a clinical study model through workshops and collaborations with some of Sweden’s most experienced clinicians in the field.

Planning and inclusion of most Swedish regions in the main study calls for intricate collaborative planning with specialists and users for assembling of complex plans and existing clinical practice.Implementation: If the study is successful, the model can be implemented in clinical practice in Swedish health care for a large group of palliative patients.