AIHEMAF-P: An Innovative Healthcare Model for Atrial Fibrillation Patients.

Atrial fibrillation (AF) is one of the most common cardiac arrhythmias of clinical relevance and a major cause of cardiovascular morbidity and mortality. Following a diagnosis of AF, patients are directed towards therapy with anticoagulant drugs to reduce the thromboembolic risk and antiarrhythmics to control their cardiac rhythm, with periodic follow-up checks. Despite the great ease of handling these drugs, we soon realized the need for follow-up models that would allow the appropriateness and safety of these pharmacological treatments to be monitored over time.

A New Case Manager for Diabetic Patients: A Pilot Observational Study of the Role of Community Pharmacists and Pharmacy Services in the Case Management of Diabetic Patients.

The adherence of type 2 diabetes mellitus (DM2) patients with an individual care plan (ICP) is often not satisfactory, nor does it allow for a significant improvement in outcome, because of poor accessibility to services, poor integration of pathway articulations, poor reconciliation with the patient's life, or the lack of a constant reference person. The purpose of this study was to evaluate the contribution of community pharmacists and pharmacy services in improving adherence with periodic controls in DM2. The study was conducted at a rural pharmacy.

Healthcare continuity from hospital to territory in Lombardy: TELEMACO project.

Objectives: To verify implementation and use of TELEMACO (TELEMedicina Ai piccoli COmunilombardi; http://www.telemaco.regione.

Telemedicine: the role of specialist second opinion for GPs in the care of hypertensive patients.

Rationale: To evaluate the feasibility of a second-opinion consultation in supporting general practitioners (GPs) during the daily diagnosis and therapeutic management of patients with essential hypertension.

Methods: Italian GPs were encouraged to follow-up their patients by the use of the Telemedicine Service. All known hypertensive patients with signs and symptoms (teleconsultation for symptoms) and all asymptomatic patients (teleconsultation for clinical control) undergoing a visit by their GPs were enrolled.

The SUMMA Project: a feasibility study on telemedicine in selected Italian areas.

Telemedicine is achieving relevant clinical importance in rural areas in the management of patients. The Second opinion Unificata per Medici di Medicina generAle (SUMMA) Project was designed to evaluate the feasibility of a joint telemedicine service application across general practitioners and clinical specialists in Italy. The secondary objective of the study included the comparison of telemedicine with the routine general practitioners' approach and a cost-effectiveness evaluation.

Wireless-accessible sensor populations for monitoring biological variables.

The current health-care infrastructure is generally considered to be inadequate to meet the needs of an increasingly older population. We have investigated the feasibility of a passive in-home monitoring system based on wireless accessible sensor populations (WASP). In an EU-funded project we have identified the system architecture and the sensors required to gather data from elderly patients by continuous monitoring.

Chronic heart failure home-based management with a telecardiology system: a comparison between patients followed by general practitioners and by a cardiology department.

A group of patients with chronic heart failure (CHF) were followed by general practitioners (GPs) with a telecardiology system, and a second group of patients were followed by a home-based telemonitoring (HBT) protocol with medical and nursing supervision. The 212 GP patients were older than the 226 HBT patients, mostly women, with CHF secondary to chronic hypertension, less self-sufficient and with a non-optimized therapy. The mean number of telephone calls was 2.

Centenary of tele-electrocardiography and telephonocardiography - where are we today?

Telecardiology applications can be categorized as pre-hospital, in-hospital and post-hospital. The major purpose of pre-hospital 12-lead electrocardiographic diagnosis is the early detection of acute myocardial infarction with ST-segment elevation and the communication of that information to the receiving emergency physician before the arrival of the patient. In-hospital telecardiology is used between small hospitals in rural regions and main hospitals.

Incidence of atrial fibrillation in an Italian population followed by their GPs through a telecardiology service.

Background: Atrial fibrillation (AF) is the most common sustained cardiac tachyarrhythmia and is often an occasional diagnosis in the absence of known cardiac disease. The aim of this study is to describe an Italian patient population with AF followed by their General Practitioners (GPs) using a telecardiology service.

Methods: A total of 655 Italian GPs were equipped with a portable electrocardiographer.

[Cardiac event recorder yields more diagnoses than 24-hour Holter monitoring in patients with palpitations].

Background: Palpitations are a common symptom that sometimes results from a substantial cardiac arrhythmia. A 24-hour Holter monitoring is usually used, but the yield of this instrument is low in patients whose symptoms occur infrequently. The aim of this study was to compare the diagnostic yield and the cost-effectiveness of transtelephonic event recorder (TER) with those of Holter monitoring in patients with intermittent palpitations.

A pilot study of nurse-led, home-based telecardiology for patients with chronic heart failure.

We assessed the feasibility of home-based telecardiology for patients with chronic heart failure (CHF). Seventy-four CHF patients were enrolled into a programme of telephone follow-up and single-lead electrocardiography (ECG) monitoring. The patients transmitted their ECG data by fixed telephone line to a receiving station, where a nurse was available for an interactive teleconsultation.

Boario Home Care Project: an Italian telemedicine experience.

The use of telemedicine appears particularly promising in cardiovascular disease, because the cost/effectiveness ratio of an early, tailored intervention, in terms of life-saving and functional recovery is demonstrated. Boario Home Care project was born in 1998, with the aim of applying the new models of disease management and the new technology on the territory. In the first phase the project was to realize a telematic network for the General Practitioners in a mountain territory; In the second phase the project was extended to the regional and then national territory and the number of enrolled GPs increased.

Assessment of prehospital chest pain using telecardiology.

Two hundred general practitioners were equipped with a portable electrocardiograph which could transmit a 12-lead electrocardiogram (ECG) via a telephone line. A cardiologist was available 24 h a day for an interactive teleconsultation. In a 13-month period there were 5073 calls to the telecardiology service and 952 subjects with chest pain were identified.