Telemonitoring for patients with chronic heart failure: a systematic review.

Full Abstract

BACKGROUND:
Telemonitoring, the use of communication technology to remotely monitor health status, is an appealing strategy for improving disease management.

METHODS AND RESULTS:
We searched Medline databases, bibliographies, and spoke with experts to review the evidence on telemonitoring in heart failure patients. Interventions included:
telephone-based symptom monitoring (n = 5), automated monitoring of signs and symptoms (n = 1), and automated physiologic monitoring (n = 1). Two studies directly compared effectiveness of 2 or more forms of telemonitoring. Study quality and intervention type varied considerably. Six studies suggested reduction in all-cause and heart failure hospitalizations (14% to 55% and 29% to 43%, respectively) or mortality (40% to 56%) with telemonitoring. Of the 3 negative studies, 2 enrolled low-risk patients and patients with access to high quality care, whereas 1 enrolled a very high-risk Hispanic population. Studies comparing forms of telemonitoring demonstrated similar effectiveness. However, intervention costs were higher with more complex programs (8383 dollars per patient per year) versus less complex programs (1695 dollars per patient per year).

CONCLUSION:
The evidence base for telemonitoring in heart failure is currently quite limited. Based on the available data, telemonitoring may be an effective strategy for disease management in high-risk heart failure patients.

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Author information

Author/s: Chaudhry, Sarwat I (SI); Phillips, Christopher O (CO); Stewart, Simon S (SS); Riegel, Barbara (B); Mattera, Jennifer A (JA); Jerant, Anthony F (AF); Krumholz, Harlan M (HM);

Affiliation: Department of Internal Medicine, Section of General Medicine, Yale University School of Medicine, New Haven, Connecticut 06520-8025, USA.

Grants: 3 R01 HL080228-01S1 (Agency:NHLBI NIH HHS) ; R01 HL080228-01 (Agency:NHLBI NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review

Journal: Journal of cardiac failure (J Card Fail), published in United States. (Language: eng)

Reference: 2007-Feb; vol 13 (issue 1) : pp 56-62

Dates: Created 2007/03/06; Completed 2007/03/12; Revised 2008/11/20;

PMID: 17339004, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged
Chronic Disease
Female
Heart Failure - diagnosis
Humans

Male
Middle Aged
Monitoring, Physiologic
Randomized Controlled Trials as Topic
Telemedicine

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