Telemonitoring for Patients With Chronic Heart Failure: A Systematic Review

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...

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Bibliographic Details
Published in:Journal of cardiac failure 2007-02, Vol.13 (1), p.56-62
Main Authors: Chaudhry, Sarwat I., MD, Phillips, Christopher O., MD, Stewart, Simon S., PhD, Riegel, Barbara, DNSc, RN, CS, Mattera, Jennifer A., MPH, Jerant, Anthony F., MD, Krumholz, Harlan M., MD, SM
Format: Article
Language:English
Subjects:
Aged
Cardiovascular
Chronic Disease
Disease management
Female
Heart Failure - diagnosis
Humans
Male
Middle Aged
Monitoring, Physiologic
Randomized Controlled Trials as Topic
Telemedicine
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Summary: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 per patient per year) versus less complex programs ($1695 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.
ISSN:1071-9164
1532-8414
DOI:10.1016/j.cardfail.2006.09.001