Telehealth interventions for chronic heart failure lack comprehensive economic evaluations across the 32 included studies, leaving their true cost-effectiveness unknown due to poor evidence quality.
Are telehealth interventions cost-effective compared to usual care in patients with chronic heart failure?
The cost-effectiveness of telehealth interventions in chronic heart failure remains unknown due to poor methodological quality and lack of comprehensive economic analyses in existing literature.
OBJECTIVES: Evidence exists that telehealth interventions (e.g., telemonitoring, telediagnostics, telephone care) in disease management for chronic heart failure patients can improve medical outcomes, and we aim to give an overview of the cost-effectiveness of these interventions. METHODS: Based on the literature search on "heart failure" in combination with "cost" and "telehealth" we selected 301 titles and abstracts. Titles and abstracts were screened for a set of inclusion criteria: telehealth intervention, heart failure as the main disease, economic analysis present and a primary study performed. In the end, thirty-two studies were included for full reading, data extraction, and critical appraisal of the economic evaluation. RESULTS: Most studies did not present a comprehensive economic evaluation, consisting of the comparison of both costs and effects between telehealth intervention and a comparator. Data on telehealth investment costs were lacking in many studies. The few studies that assessed costs and consequences comprehensively showed that telehealth interventions are cost saving with slight improvement in effectiveness, or comparably effective with similar cost to usual care. However, the methodological quality of the studies was in general considered to be low. CONCLUSIONS: The cost-effectiveness of telehealth in chronic heart failure is hardly ascertained in peer reviewed literature, the quality of evidence is poor and there was a difficulty in capturing all of the consequences/effects of telehealth intervention. We believe that without full economic analyses the cost-effectiveness of telehealth interventions in chronic heart failure remains unknown.
Grustam et al. (Wed,) conducted a review in Chronic heart failure (n=32). Telehealth interventions vs. Usual care was evaluated on Cost-effectiveness. Telehealth interventions for chronic heart failure lack comprehensive economic evaluations across the 32 included studies, leaving their true cost-effectiveness unknown due to poor evidence quality.