Optimization of ambulatory monitoring of patients with heart failure using telecardiology (OSICAT)

Summary Background The prevalence of heart failure has been steadily increasing over the past twenty years. It is the first cause of unplanned hospitalizations for patients aged 60 years and older in France, and contributes to the congestion of emergency departments. The economic burden of heart failure is increasing, emphasizing the importance of developing ambulatory care and prevention strategies. Methods OSICAT is a prospective, randomized, controlled, multicenter trial for patients with chronic heart failure, developed in the South of France. The telecardiology program involves a daily scale assessment, a device asking the patients daily questions on the symptoms associated with their heart failure, and regular telephone calls made by nurses. All-cause mortality and hospitalization will be assessed at six, 12 and 18 months in the two groups. A cost-utility study will be performed. The economic analysis will adopt the healthcare payer's perspective and will take into account direct costs, indirect costs and informal care costs. The study will evaluate social and organizational acceptability. Results The first results of the OSICAT trial are expected in 2015. Discussion A combination of both the constant increase in heart failure prevalence and the downsizing of acute hospital inpatient capacity requires the development of outpatient support programs. More and more evidence emphasizes the effectiveness of comprehensive, multidisciplinary, coordinated heart failure patient care, including patient education. This can reduce mortality and incidence of all-cause hospitalizations. However, recent data from the literature shows conflicting results. A new trial is therefore required to provide consistent answers. Conclusion OSICAT hopes to clarify these uncertainties. The project will facilitate home stay for patients with guarantees of care quality and security, prevent isolation, and widespread education of heart failure patients.