LIFE LONG-MONITORING OF FRAIL PATIENTS WITH CHRONIC DISEASES
Who is the patient population?
Patients with chronic diseases usually have in common some peculiarities mainly related to their age and their limitations in everyday life that convert to serious social problems and distresses.
In Cluster 10, the target population is elderly patients with one or more chronic diseases (heart failure and/or COPD and/or diabetes) who can be considered "frail" because of their critical social situation.
What characterises the interventions?
- The telemedicine application includes a complete set of biomedical devices that allows the remote monitoring of more clinical paramaters, not related just to one disease.
- Telemedicine allows the alarm management in case of patient clinical parameters out of range
- The telemedicine intervention is conceived to address not just the patient clinical requirements but also the social ones. Indeed the tele-health application for clinical parameters monitoring is completed by a telecare service that ensures a careful surveillance of patients everyday needs and the early detection of critical emergency situations.
- As well as that one in the control group, patient receiving the intervention is followed during 12 months by his general practitioner who usually represents the first reference point also in usual care.
- The trial aims to demonstrate how telemedicine can improve patients quality of life and health status and reduce the access to hospital and GP facilites.
- A parallel evaluation will be carried out on the economic and organizational aspects of telemedicine, as well as its acceptability by the users (both patients and professionals).
What are the expected results at cluster level?
Given the particular composition of the telemedicine application, the trial allows to evaluate how such service helps to improve patient conditions also by a social point of view. The results obtained can reflect a better organizational and cost effective management of the frail patient and the improvement of health and social care professionals working lives.
Which regions participate?
Timing
| Start of trial/inclusion of patients | Inclusion complete* | Follow-up period ended | Expected time of publishing of results* | |
| Veneto Region | May 2012 | July 2012 | July 2013 | Ultimo 2013 |
*Please note that these are estimates and are subject to change as the trial progress.