Comparative Effectiveness of Telemonitoring Versus Usual Care for Heart Failure: a Systematic Review and Meta-Analysis.

Authors Yun JE , Park JE , Park HY , Lee HY , Park DA - More
Category Systematic review
Journal Journal of cardiac failure
Year 2018

BACKGROUND: This study aimed to evaluate the effectiveness of telemonitoring (TM) in the management of patients with heart failure (HF). METHODS AND RESULTS: We searched Ovid-Medline, Ovid-EMBASE, and the Cochrane Library for randomized controlled trials published through April 2016. Outcomes of interest included clinical effectiveness (mortality, hospitalization, and emergency room visits) and patient-reported outcomes. TM was defined as the transmission of individual biological data such as weight, blood pressure, and heart rate. Thirty-seven randomized controlled trials (9,582 patients) of TM met the inclusion criteria: 24 studies on all-cause mortality, 17 studies on all-cause hospitalization, 12 studies on HF-related hospitalization, and 5 studies on HF-related mortality. The risks of all-cause mortality (risk ratio [RR], 0.81; 95% confidence interval [CI], 0.70-0.94) and HF-related mortality (RR, 0.68; 95% CI, 0.50-0.91) were significantly lower in the TM group than in the usual care group. TM showed a significant benefit when three or more biological data are transmitted or when transmission occurred daily. TM also reduced mortality risk in studies that monitored patients' symptoms, medication adherence, or prescription changes. CONCLUSIONS: TM intervention reduces the mortality risk in patients with HF, and intensive monitoring with more frequent transmissions of patient data increases its effectiveness.

Epistemonikos ID: e3e238e5865e174c1fa964cfa657dbea8809024a