• Piotr Wańczura, David Aebisher, Wojciech Stecko, Hubert Bukowski, Marek Kos, Andrzej Przybylski, and Jarosław Zalewski.
• Pol. Arch. Med. Wewn. 2025 Feb 13.

IntroductionTelemedicine is intended to provide medical care to patients in remote areas.ObjectivesThis study sought to investigate whether the application of e-health solutions for patients with heart failure (HF) who live in regions of social exclusion would improve their functional performance and quality of life (QoL).Patients And MethodsIn this prospective, non-controlled study carried out between June and December 2023, HF patients were enrolled in 14 primary care units located in 5 rural voivodeships in eastern Poland. All patients were evaluated at baseline and after 3 months using the New York Heart Association (NYHA) scale, Chronic Heart Failure Questionnaire (CHFQ), and EuroQol Visual Analogue Scale (EQVAS), and monitored by a general practitioner under the supervision of a cardiologist.ResultsIn 429 patients with HF, more than 100 000 telemedical examinations/consultations were performed resulting in 575 treatment modifications. During the 3-month program, one patient died. Simultaneously, an improvement in NYHA scale by median of 1 class (interquartile range 0-1, P <0.001) was identified. A 6% improvement in QoL was found in emotional function measured by CHFQ (P <0.001) while a 7.7% improvement in subjective health status measured by EQVAS (P <0.001). A history of atrial fibrillation (odds ratio [OR] 1.539, 95% confidence interval [CI] 1.021-2.353) and no history of cancer (OR 2.793, 95% CI 1.224-6.369) were associated with the NYHA class improvement.ConclusionsThe applied telemedical model of care under the specialist's supervision was associated with an improvement in NYHA class and QoL in the HF population from regions of social exclusion.

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