[Disease management for heart failure patients: role of wireless technologies for telemedicine. The ICAROS project].

Healthcare costs for heart failure are increasing The need for a better care however has to be matched with a policy of cost containment A way to improve the cost effectiveness of heart failure care is the disease management approach in which therapy education and follow up are tailored for each patient by a multidisciplinary team Such a complex intervention can be facilitated by the use of telemedicine which allows the remote control of considerable amounts of clinical data In Italy a few studies with telemedicine have been reported A recent development in this field is represented by the ICAROS project Integrated Care vs Conventional Intervention in Cardiac Failure Patients Randomized Open Label Study whose aim is to improve the clinical and psychological care of heart failure patients employing advanced wireless telecommunication technology So far we randomized 60 patients 30 in usual ambulatory care 30 in an intensive treatment group The latter patients were instructed to use a portable computer to get in touch daily with the heart failure clinic and receive feedback instruction for the management of drug therapy and daily problems At the first year of follow up the treatment group showed good compliance to drug prescriptions and could easily handle the portable computer The preliminary results of this ongoing study support the feasibility and appropriateness of new technologies for the management of heart failure even in elderly patients in whom a limited expertise with these appliances could have been anticipated