Clinical investigation: congestive heart failureRandomized trial of a daily electronic home monitoring system in patients with advanced heart failure: the Weight Monitoring in Heart Failure (WHARF) trial☆
Section snippets
Study population
Patients hospitalized with New York Heart Association (NYHA) class III or IV heart failure, with a left ventricular ejection fraction, measured within 6 months of enrollment, of ≤35% were eligible for enrollment. These patients had to weigh <400 pounds (scale limit), have the ability to stand for at least 20 seconds without holding the wall, and speak either English or Spanish.
Patients were recruited from 16 clinical sites throughout the continental United States (8 cardiac transplant centers
Results
From July 1998 through December 2000, a total of 280 patients from 16 medical centers across the United States underwent randomization: 138 received the AlereNet system plus standard heart failure care and 142 were assigned to receive standard heart failure care. The mean age of the population was 59 ± 15 years and 68% were male. The mean follow-up period was 169 ± 51 days. During the study, 32 patients either refused follow-up data collection or were lost to follow-up. Seven patients received
Discussion
This study is the first multicenter, prospective, randomized, controlled clinical trial to examine the effect of a technology-based heart failure daily weight and symptom management system on hospitalization rates, mortality, and quality of life in patients hospitalized with advanced heart failure (ie, as measured by plasma norepinepherine levels, 6-minute walk distance, ejection fraction, serum sodium and creatinine and outcomes). Although not designed as a mortality study, we demonstrated
Acknowledgements
We thank Dr Mariell Jessup for her thoughtful editorial review of this manuscript.
References (14)
Heart failure disease management programsefficacy and limitations
Am J Med
(2001)- et al.
Evolving trends in the epidemiologic factors of heart failurerationale for preventive strategies and comprehensive disease management
Am Heart J
(1997) - et al.
A systematic review of randomized trials of disease management programs in heart failure
Am J Med
(2001) - et al.
Prevention of hospitalizations for heart failure with an interactive home monitoring program
Am Heart J
(1998) - et al.
Use of telemonitoring to decrease the rate of hospitalization in patients with severe congestive heart failure
Am J Cardiol
(1999) - et al.
The fragility of cardiovascular clinical trial results
J Card Fail
(2002) - Hunt SA, Baker DW, Chin MH, et al. ACC/AHA guidelines for the evaluation and management of heart failure in the adult:...
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Supported by grants from Alere Medical, Incorporated.