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April 25, 2026Journal of the American College of Cardiology383 citations

A Meta-Analysis of Remote Monitoring of Heart Failure Patients

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CKCatherine KlersyASAnnalisa De SilvestriGGGabriella Gabutti

Key Result

Remote patient monitoring significantly reduced the risk of death (RCTs: RR 0.83, 95% CI 0.73-0.95; p=0.006) and hospitalizations compared with usual care in patients with chronic heart failure.

Key Points

  • This study aims to evaluate the effectiveness of remote patient monitoring in improving outcomes for chronic heart failure patients.
  • Meta-analysis of literature from January 2000 to October 2008 focusing on randomized controlled trials and cohort studies on heart failure management.
  • Included 96 articles, with 20 randomized controlled trials and 12 cohort studies.
  • Median follow-up was 6 months for RCTs and 12 months for cohort studies.
  • Remote patient monitoring significantly reduced mortality (RCTs: RR 0.83, 95% CI 0.73-0.95, p=0.006; cohort studies: RR 0.53, 95% CI 0.29-0.96, p<0.001).
  • Hospitalizations were also lower due to RPM (RCTs: RR 0.93, 95% CI 0.87-0.99, p=0.030; cohort studies: RR 0.52, 95% CI 0.28-0.96, p<0.001).
  • The impact on reducing events was more pronounced in cohort studies than RCTs.

Study Design

Type

Meta-Analysis (n=8,612)

Structured PICO

Does remote patient monitoring reduce deaths and hospitalizations in patients with chronic heart failure?

P
Population
8,612 patients with chronic heart failure pooled from 20 RCTs (n=6,258) and 12 cohort studies (n=2,354)
I
Intervention
Remote patient monitoring (RPM) via regularly scheduled structured telephone contact or electronic transfer of physiological data using remote external, wearable, or implantable electronic devices
C
Comparator
Usual care (in-person visit)
O
Outcome
Number of deaths and hospitalizationshard clinical

Remote patient monitoring significantly reduces mortality and hospitalizations in patients with chronic heart failure compared to usual care.

Main Result

Effect estimate: RR 0.83 (95% CI 0.73 to 0.95)

p-value: p=0.006

Abstract

OBJECTIVES: The purpose of this study was to assess the effect of remote patient monitoring (RPM) on the outcome of chronic heart failure (HF) patients. BACKGROUND: RPM via regularly scheduled structured telephone contact between patients and health care providers or electronic transfer of physiological data using remote access technology via remote external, wearable, or implantable electronic devices is a growing modality to manage patients with chronic HF. METHODS: After a review of the literature published between January 2000 and October 2008 on a multidisciplinary heart failure approach by either usual care (in-person visit) or RPM, 96 full-text articles were retrieved: 20 articles reporting randomized controlled trials (RCTs) and 12 reporting cohort studies qualified for a meta-analysis. RESULTS: Respectively, 6,258 patients and 2,354 patients were included in RCTs and cohort studies. Median follow-up duration was 6 months for RCTs and 12 months for cohort studies. Both RCTs and cohort studies showed that RPM was associated with a significantly lower number of deaths (RCTs: relative risk RR: 0.83, 95% confidence interval CI: 0.73 to 0.95, p = 0.006; cohort studies: RR: 0.53, 95% CI: 0.29 to 0.96, p < 0.001) and hospitalizations (RCTs: RR: 0.93, 95% CI: 0.87 to 0.99, p = 0.030; cohort studies: RR: 0.52, 95% CI: 0.28 to 0.96, p < 0.001). The decrease in events was greater in cohort studies than in RCTs. CONCLUSIONS: RPM confers a significant protective clinical effect in patients with chronic HF compared with usual care.

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Cite This Study

Klersy et al. (2009) conducted a meta-analysis in chronic heart failure (n=8,612). remote patient monitoring (RPM) vs. usual care (in-person visit) was evaluated on deaths (RCTs) (RR 0.83, 95% CI 0.73 to 0.95, p=0.006). Remote patient monitoring significantly reduced the risk of death (RCTs: RR 0.83, 95% CI 0.73-0.95; p=0.006) and hospitalizations compared with usual care in patients with chronic heart failure.

synapsesocial.com/papers/69ec32a66763cbe2e0f529a7https://doi.org/10.1016/j.jacc.2009.08.017
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