Heart failure (HF) is a severe disease with increasing prevalence, impaired survival and high re-hospitalisation rates. Yet, home-telemonitoring (HTM) might decrease HF hospitalizations.

To report our experience in the implementation, acceptability and efficacy of HTM, led by a HF nurse.

All HF patients included in the HTM program of Reims University Hospital between July 2020 and December 2021 were included. HTM consisted in patient daily weight and HF symptoms transmissions through a connected device. After first data treatment by the service provider, relevant alerts were transmitted to the local HTM team, associating HF nurse, cardiologists and secretary. Each alert was systematically first treated by the HF nurse, orienting patient management according to the algorithm described in Fig. 1A.

Among the 97 patients included during the 18 months of the study period, 72% were male, 78% had HF-rEF and 49% had coronary disease. Mean age, LVEF and NTproBNP were 60±12 years, 32±11% and 2323±2610pg/mL, respectively. Regarding HTM patient experience, device observance was 76±23% and 65% answered as very satisfied, 34% satisfied and 1% had low satisfaction. Majority (97%) of patients perceived HTM device as easy to use, 97% would recommend it to other HF patients, 82% felt reassured and 53% considered that it prevented consultations and/or hospitalizations. In total, 782 HTM alerts were generated and 157 (20%) classified as relevant for transmission to the HTM local team by the service provider. Half of patients (53%) presented at least one alert, and 28 at least 2 alerts (Fig. 1B). First alert occurred around 70±87 days after inclusion and constituted in: 1) weight gain (52%); 2) HF symptoms (41%); or 3) both (6%) (Fig. 1B). After 1st alert, 12 patients had diuretic dose increased and/or introduced and 11 were oriented to their general practitioner (GP), suggesting that without HTM, between 12 and 21% of patients would have consulted emergency department and/or been rehospitalized for worsening HF.

HTM led by HF nurse is simple to implement and well accepted by HF patients, providing that each alert is analyzed and patient management adapted in coordination with cardiologists and GPs. This suggests HF nurses can help improving care and free medical time in HTM.