CONGRESS ABSTRACT

Background: Heart failure (HF) and type 2 diabetes (T2DM) are prevalent public health issues. This study aimed to evaluate the effectiveness of a telemedicine program designed to manage HF and T2DM at home, with a specific focus on promoting lifestyle changes. Methods: Patients were recruited during cardiology outpatient visits and randomly assigned to either the Intervention Group (IG) or the Control Group (CG). Over six months, the IG received teleassistance support from a nurse case manager, who encouraged lifestyle changes. They also benefited from telemonitoring of vital signs and daily step tracking. An app was utilized to record and monitor daily medication adherence and clinical parameters. Additionally, patients could self-report symptoms and communicate with a nurse through a chat and video system. The CG received routine care. The primary outcome measured was the difference in the distance walked during a six-minute walk test (6MWT) between baseline (T0) and after six months (T6). The secondary outcome includes improving the physical activity scale for older adults (PASE). Results: A total of 163 patients (84% male) were randomized, with 82 in the IG and 81 in the CG. The mean age was 71±9 years in the IG and 74±8 years in the CG (p=0.0961). After six months, the IG walked further than baseline, with a mean (95% CI) change in the Δ6MWT of 11.76 meters [0.78, 22.74]. In contrast, the CG showed a decrease in Δ6MWT of -20.68 meters [-33.01, -8.35], with a statistically significant difference between groups (p<0.0000). In the CG, 71% of patients experienced a worsening of their exercise tolerance, compared to only 41% in the IG who showed improvement. The PASE, which assesses self-reported occupational, household, and recreational activities over one week, decreased in the CG over the six months from T0: 96.16 (95% CI: 84.44, 107.88) to T6: 81.14 (95% CI: 68.81, 93.47); p=0.0212. Conversely, the PASE scores increased in the IG, although not significantly, from T0: 102.52 (95% CI: 90.29, 114.74) to T6: 108.98 (95% CI: 94.76, 123.19); p=0.2914. The difference between groups was significant (p=0.0190). Conclusions: This study provides evidence of the efficacy of a telemedicine home-based management model in maintaining healthy lifestyles for patients with both heart failure and type 2 diabetes. The program improved self-management, empowered patients regarding their conditions, and increased their knowledge and ability to recognize symptoms early.