Serviço de Cardiologia, Hospital Moinhos de Vento, R. Ramiro Barcelos, 910 - Moinhos de Vento, Porto Alegre, 90035-000, Brazil.
Heart Failure Clinic, Hospital de Clinicas de Porto Alegre and Nursing School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
ESC Heart Fail. 2021 Dec;8(6):5523-5530. doi: 10.1002/ehf2.13516. Epub 2021 Sep 18.
To evaluate a telemonitoring strategy based on automated text messaging and telephone support after heart failure (HF) hospitalization.
The MESSAGE-HF study is a prospective multicentre, randomized, nationwide trial enrolling patients from 30 clinics in all regions of Brazil. HF patients with reduced left ventricular ejection fraction (<40%) and access to mobile phones are eligible after an acute decompensated HF hospitalization. Patients meeting eligibility criteria undergo an initial feasibility text messaging assessment and are randomized to usual care or telemonitoring intervention. All patients receive a HF booklet with basic information and recommendations about self-care. Patients in the intervention group receive four daily short text messages (educational and feedback) during the first 30 days of the protocol to optimize self-care; the feedback text messages from patients could trigger diuretic adjustments or a telephone call from the healthcare team. After 30 days, the frequency of text messages can be adjusted. Patients are followed up after 30, 90, and 180 days, with final status ascertained at 365 days by telephone. Our primary endpoint is the change in N-terminal pro-brain natriuretic peptide (NT-proBNP) levels after 180 days. Secondary endpoints include changes in NT-proBNP after 30 days; health-related quality of life, HF self-care, and knowledge scales after 30 and 180 days; and a composite outcome of HF hospitalization and cardiovascular death, adjudicated by a blinded and independent committee.
The MESSAGE-HF trial is evaluating an educational and self-care promotion strategy involving a simple, intensive, and tailored telemonitoring system. If proven effective, it could be applied to a broader population worldwide.
评估一种基于自动短信和电话支持的心力衰竭（HF）住院后远程监测策略。
MESSAGE-HF 研究是一项前瞻性、多中心、随机、全国性试验，纳入了来自巴西所有地区 30 个诊所的患者。急性失代偿性 HF 住院后，左心室射血分数降低（<40%）且可使用手机的 HF 患者符合入选标准。符合入选标准的患者接受初始可行性短信评估，并随机分为常规护理或远程监测干预组。所有患者均获得 HF 小册子，其中包含有关自我护理的基本信息和建议。干预组患者在方案的最初 30 天内每天接收四条简短的短信（教育和反馈），以优化自我护理；患者的反馈短信可能会触发利尿剂调整或医疗团队的电话。30 天后，可以调整短信的频率。患者在 30、90 和 180 天后进行随访，最终状态在 365 天时通过电话确定。我们的主要终点是 180 天后 N 末端脑利钠肽前体（NT-proBNP）水平的变化。次要终点包括 30 天后 NT-proBNP 的变化；30 和 180 天后健康相关生活质量、HF 自我护理和知识量表的变化；以及由盲法和独立委员会裁定的 HF 住院和心血管死亡的复合结局。
MESSAGE-HF 试验正在评估一种涉及简单、强化和定制远程监测系统的教育和自我护理促进策略。如果证明有效，它可以在全球更广泛的人群中应用。
