Telemonitoring for patients with chronic heart failure: a systematic review.
BACKGROUND
Telemonitoring, the use of communication technology to remotely monitor health status, is an appealing strategy for improving disease management.


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).


CONCLUSIONS
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.
Chaudhry
Sarwat I
SI
Department of Internal Medicine, Section of General Medicine, Yale University School of Medicine, New Haven, Connecticut 06520-8025, USA.
Phillips
Christopher O
CO
Stewart
Simon S
SS
Riegel
Barbara
B
Mattera
Jennifer A
JA
Jerant
Anthony F
AF
Krumholz
Harlan M
HM
D000368:Aged; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D016032:Randomized Controlled Trials as Topic; D017216:Telemedicine