Remote monitoring significantly reduced total heart failure hospitalizations (IRR 0.81), first heart failure hospitalizations (RR 0.82), and all-cause mortality (RR 0.90) compared to standard care.
Meta-Analysis (n=31,669)
Does remote monitoring reduce heart failure hospitalizations and all-cause mortality in patients with chronic heart failure?
Remote monitoring, particularly invasive hemodynamic monitoring for total hospitalizations and structured telephone support for mortality, consistently improves clinical outcomes in heart failure patients across diverse subgroups.
Effect estimate: IRR 0.81 (95% CI 0.72-0.91)
Remote monitoring (RM) is effective for managing heart failure (HF), but it remains unclear which patients benefit most from which RM modality. We conducted a meta-analysis of 79 randomised trials including 31,669 patients comparing RM with standard care for total and first HF hospitalisations and all-cause mortality. Subgroup analyses evaluated effects by geographic region and HF status, and meta-regression assessed the influence of age, left ventricular ejection fraction, New York Heart Association class, sex, and publication year. Network meta-analysis ranked RM modalities using Surface Under the Cumulative Ranking scores. Overall, RM reduced total HF hospitalisations (incidence rate ratio 0.81, 95% confidence interval CI 0.72-0.91), first HF hospitalisations (risk ratio 0.82, 95% CI: 0.76-0.88), and all-cause mortality (risk ratio 0.90, 95% CI: 0.84-0.95). Subgroup and meta-regression analyses showed consistent benefits across patient and study characteristics without significant interaction effects. In network meta-analysis, invasive hemodynamic monitoring ranked highest for reducing total HF hospitalisations, while structured telephone support ranked highest for reducing first HF hospitalisation and all-cause mortality. RM consistently improves HF outcomes across a range of patient and study characteristics, supporting its broad use. However, based on these characteristics, current evidence does not allow targeted RM implementation for specific patients most likely to benefit.
Scholte et al. (Tue,) conducted a meta-analysis in Heart Failure (n=31,669). Remote monitoring vs. Standard care was evaluated on Total heart failure hospitalizations (IRR 0.81, 95% CI 0.72-0.91). Remote monitoring significantly reduced total heart failure hospitalizations (IRR 0.81), first heart failure hospitalizations (RR 0.82), and all-cause mortality (RR 0.90) compared to standard care.