Paper of the Month

September 2018

Efficacy of telemedical interventional management in patients with heart failure (TIM-HF2): a randomised, controlled, parallel-group, unmasked trial. The Lancet, Volume 392 (2018). DZHK authors: Wegscheider, Edelmann, Schöbel, Dreger, Anker, Stangl

The Telemedical Interventional Management in Heart Failure II (TIM-HF2) trial was a prospective, randomised, controlled, multicentre trial performed in Germany enrolling 1571 patients assigned to either remote patient management or usual care.  TIM-HF2 patients had heart failure (HF), were in NYHA class II or  III, had a hospital admission for HF within the last 12 months, and, had no major depression. The telemedical centre provided physician-led medical support and patient management 24 h a day. The primary outcome was percentage of days lost due to unplanned cardiovascular hospital admissions or all-cause death.

The trial results showed a 20% reduction of the combined end point and a 30% reduction of all-cause death rate in the remote patient management group. These favorable findings were consistent throughout all subgroups. Of note, patients from rural regions showed similar results as compared to urban patients.

The authors suggest that in a carefully chosen HF patient population a structured remote patient management with 24/7 availability of physicians and heart failure nurses allowing prompt reaction according to the individual patient risk is able to reduce unplanned hospital admissions due to HF and all-cause mortality.