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Telemedicine System Effective for Carvedilol Delivery

Automated, remote monitoring just as effective as frequent clinic visits

WEDNESDAY, April 12 (HealthDay News) -- In patients with congestive heart failure, using an automated telemedicine system to remotely monitor medication is as effective as frequent outpatient clinic visits, according to a study published in the April issue of the American Heart Journal.

Jeffrey A. Spaeder, M.D., of the Johns Hopkins Bayview Medical Center in Baltimore, and colleagues conducted a three-month study of 49 patients with New York Heart Association class II and III left ventricular systolic dysfunction who were not taking beta-blockers and were tolerating the appropriate afterload-reducing therapy.

Half the sample (24 patients) received clinic-only carvedilol titrations, and the remainder had clinic visits combined with automated telemedicine system TeleWatch (TW) monitoring. All patients had biweekly clinic visits and those in the TW group were remotely monitored on a daily basis.

The mean final daily dose of carvedilol was almost identical between the two groups, and because the remotely monitored titrations were as successful as those in the clinic, the time to reach the final dose of carvedilol was significantly shorter in the TW group. Of the five serious adverse events during the study, four were in the TW group, of which TW prospectively detected two.

"The ability to successfully perform these titrations remotely as successfully as in-clinic visits has implications not only for carvedilol titration in patients with congestive heart failure, but also for a variety of medications that have benefits that are dose-dependent but also have potentially significant but measurable side effects," the authors conclude.

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