Journal of Telemedicine and Telecare > Volume 14, Number 1 > Pp. 17-21

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RESEARCH Original article

The TeleGuard trial of additional telemedicine care in CAD patients. 1 Utilization of the system

Alexander Katalinic ^*, Annika Waldmann ^* , Bernhard Schwaab , Gert Richardt , Abdolhamid Sheikhzadeh ^*  and Heiner Raspe ^*

^* Institute for Social Medicine, University of Luebeck, Luebeck; Curschmann-Klinik, Timmendorfer Strand; Segeberger Kliniken, Bad Segeberg, Germany

Correspondence: Dr Annika Waldmann, University of Luebeck, Institute for Social Medicine, Institute for Cancer Epidemiology e.V. Beckergrube 43-47, 23552 Luebeck, Germany (Fax: +49 451 799 2551; Email: Annika.Waldmann{at}krebsregister-sh.de)

Patients with established coronary artery disease (CAD) were recruited in 11 hospitals and randomized to an intervention (telemedicine system; n = 752) or a control group (usual medical care; n = 748). On the day before discharge, patients in the intervention group were equipped with a 12-lead event recorder and trained to use the device. Whenever they had symptoms, they could contact the call centre, transmit an ECG (without redialling) and consult a physician. During a 12-month study, 171 patients (23%) in the intervention group contacted the call centre, a total of 269 times. The main reasons for calling were chest pain and radiating pain. Pathological changes were seen in 24% of the transmitted ECGs. Only 23% of the calls were made in the first hour after onset of symptoms and a further 12% in the subsequent hour, suggesting that patients should be encouraged to use ECG transmission at an earlier stage. At follow-up, 157 patients (21%) had had at least one recurrent cardiac event (myocardial infarction, cardiac hospital stay, re-vascularization). The proportion was significantly higher in telemedicine users (35%) than in non-users (17%), P < 0.001. Regardless of utilization, the majority of the intervention patients considered that the telemedicine system was helpful (users = 93%, non-users = 89%; P = 0.095).

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				A. Waldmann, A. Katalinic, B. Schwaab, G. Richardt, A. Sheikhzadeh, and H. Raspe The TeleGuard trial of additional telemedicine care in CAD patients. 2 Morbidity and mortality after 12 months J Telemed Telecare, April 1, 2008; 14(1): 22 - 26. [Abstract] [Full Text] [PDF]