Telemedicine and remote management of patients with heart failure

Advances in telecommunication technologies have created new opportunities to provide telemedical care as an adjunct to medical management of patients with heart failure. Meta-analyses suggest that telemedicine can reduce morbidity and mortality in such patients; however, two prospective clinical tri...

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Bibliographic Details
Published in:The Lancet (British edition) 2011, Vol.378 (9792), p.731-739
Main Authors: Anker, Stefan D, Prof, Koehler, Friedrich, Prof, Abraham, William T, Prof
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cardiology. Vascular system
Chronic Disease
clinical trials
crisis intervention
General aspects
Heart
heart failure
Heart Failure - diagnosis
Heart Failure - mortality
Heart Failure - therapy
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Humans
Internal Medicine
Medical sciences
meta-analysis
morbidity
mortality
nurses
patients
physicians
prospective studies
support systems
Telemedicine
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Summary:Advances in telecommunication technologies have created new opportunities to provide telemedical care as an adjunct to medical management of patients with heart failure. Meta-analyses suggest that telemedicine can reduce morbidity and mortality in such patients; however, two prospective clinical trials not included in the analyses do not support these findings. Therefore, the effectiveness of telemedicine in heart failure is not established. Telemedicine approaches range from computer-based support systems to programmes led by nurses and physicians. Standardisation and appropriate classification of telemedical systems are needed to enable accurate interpretation of clinical trials. Here we propose a classification of four generations of telemedicine in heart failure. Not all approaches are the same and not every patient with heart failure will need telemedicine. Crisis prevention and treatment, and stabilisation and self-empowerment of patients are focuses of telemedicine in heart failure. The profile of patients who can potentially benefit from telemedicine is unknown and should be investigated in adequately powered randomised clinical trials. We are optimistic that telemedicine is an efficient approach and will become an important feature of management in heart failure.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(11)61229-4