What is actually delivered during remote therapeutic support in heart failure telemonitoring? A real-world analysis of 903 sessions

Therapeutic support/education is a required component of heart failure (HF) telemonitoring in France, yet the content effectively delivered in routine practice and the needs most frequently identified remain poorly described.

To describe the patient profile, the format of therapeutic support sessions, the topics addressed, and the strengths, difficulties, and actionable goals documented during routine remote HF telemonitoring.

Retrospective descriptive study based on structured therapeutic support reports entered by the Satelia care team between October 2025 and January 2026. All available reports were analysed (demographics, session type, living situation, themes covered, strengths, difficulties, and goals).

A total of 903 therapeutic support session reports were analysed. Mean age was 76.7 ± 12.7 years (median 79 [69–86], range 27–103; age available for n=901). Men represented 59.8% (539/901) and women 40.2% (362/901). Sessions were mostly follow-up (63.4%, n=571), with first sessions accounting for 34.6% (n=312), and other formats 2.0% (n=18). Regarding living situation, 47.1% lived as a couple (n=424), 26.7% lived alone (n=241), and 31.3% had home help and/or community nursing mentioned (n=282).

Most frequent topics were: telemonitoring programme use (63.5%, n=572), weight monitoring (in-depth) (43.8%, n=395), adherence to recommended medical follow-up (32.2%, n=290), adapted physical activity (30.0%, n=270), HF-adapted diet (28.6%, n=258), disease knowledge (23.8%, n=214), seasonal vaccination (13.4%, n=121), and medications (12.4%, n=112).

Documented strengths included good understanding of telemonitoring (54.7%, n=493), satisfaction/adherence (48.4%, n=436), awareness of regular weighing (45.8%, n=413), and knowing emergency contacts (41.1%, n=370). Key difficulties were lack of knowledge of warning signs (30.6%, n=276), limited understanding of regular weighing (17.3%, n=156), and inability to link weight gain with fluid retention (15.3%, n=138). Common goals were enrolment in group sessions (35.1%, n=316), ability to name warning signs (27.4%, n=247), and skills reinforcement (25.1%, n=226).

Remote structured therapeutic support within HF telemonitoring is feasible in an elderly, frequently supported population and largely focuses on "high-impact" self-care competencies (weight, warning signs, actions to take, lifestyle). However, persistent gaps—especially in recognizing deterioration and interpreting weight changes, support a multimodal pathway combining individual reminders, periodic "booster" sessions, and referral to group education.