Newcard telemonitoring system improves survival in comparison both with traditional approaches and other French telemonitoring systems in chronic heart failure

Abstract Background in the NEWTS3 Study, the French National Health Data System (SNDS) was used to comprehensively collect medico economic data for patients between 2017 and 2020. We have shown a decrease in all-cause mortality with the Newcard telemonitoring system (NewTM) in comparison with traditional approaches in Chronic Heart Failure (CHF). This effect seemed to be greater in the group of patients included in the specific year 2020 Purpose The aim of the NEWTS3EXT study is on one hand to confirm those results by adding 2021 and 2022 data to the follow up of the 2020 population. On the other hand, a new evaluation was performed for NewTM patients matched with patients followed by other telemonitoring French systems (TLM). Methods All NewTM patients monitored at least 3 months between 2017 and 2020 were included. For each patient, anonymised data was retrieved from the SNDS. Control Group (CG) was randomly selected from an exhaustive extraction of SNDS of patients with CHF without telemonitoring. This CG was matched in a 1:3 ratio to NewTM patients using a propensity score including baseline characteristics, presence of comorbidities and presence of significative treatments. TLM group was randomly selected from an extraction of SNDS of patients with CHF including a reimbursement of telemonitoring but not followed by Newcard. This TLM group was matched in a 1:1 ratio to NewTM patients using the same propensity score. Binomial negative GEE models were used on matched data sets to assess differences. Results 53.97 % of the patients were included during the 2020 year (571 patients). During 2020, the COVID first year, the prognosis of patients with HF is known as more positive. Despite that, we show a consistent gain in survival rates for the NewTM group (OR 0.707 p=0.0025) (fig 1) For the second arm of the study, 919 NewTM patients were matched to 919 TLM patients. We show also an increase statically significative in survival rates in the NewTM group versus TLM group at 48 months (OR 0.832 p=0.0394) (fig 2) Conclusion In this part of the NEWTS3 program, we confirm the effect on all-cause mortality of the Newcard telemonitoring system in comparison with a control group even on the specific 2020 population which is known to have a better prognostic. On the other hand, it is one of the first comparison between one specific solution and a group of others. Explaining the positive result on all-cause mortality for the NewTM must be a mix of plenty of specificities especially in a complex process like telemonitoring of HF. To help to find the best place for telemonitoring in the care pathway of HF, we can emphasize on the high level of adherence of the NewTM patients (data collected every 1.4 days) and on the precise process to ensure that every alert is followed by a medical response.