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December 1, 2018Health Affairs

Home Telemonitoring In Heart Failure: A Systematic Review And Meta-Analysis

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Why the study?

The timing or duration of home telemonitoring had not been previously studied as a variable affecting mortality and hospital use in patients with heart failure.

Does home telemonitoring reduce mortality and hospital use in patients with heart failure?

Comparison

Home telemonitoring vs comparator

Design

Systematic review and meta-analysis of randomized controlled trials

Authors

RPRenée PekmezarisSouth Shore HospitalLTLeanne M. TortezWilliam James CollegeMWMyia S. WilliamsNorthwell Health

Discussion

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Implication

Transient mortality benefit supports targeted short-term telemonitoring in HF; challenges routine long-term use given absent hospitalization effects.

Key Points

  • To evaluate the effectiveness of home telemonitoring on mortality and hospital utilization in patients with heart failure, specifically assessing the influence of monitoring duration.
  • Conducted a systematic review and meta-analysis of 26 randomized controlled trials.
  • Applied the PICOT framework to examine intervention timing and duration as key variables.
  • Home telemonitoring significantly decreased odds of all-cause mortality and heart failure-related mortality at 180 days, but effects were not sustained at 365 days.
  • Odds of all-cause hospitalization at 90 and 180 days and heart failure-related hospitalization at 180 days were not significantly altered.
  • Odds of all-cause emergency department visits significantly increased at 180 days, with home care provision showing no moderating effect on hospitalizations.

Structured PICO

Does home telemonitoring reduce mortality and hospital use in patients with heart failure?

P
Population
Patients with heart failure (pooled from 26 randomized controlled trials)
I
Intervention
Home telemonitoring
O
Outcome
Mortality (all-cause and heart failure-related) and hospital use (all-cause and heart failure-related hospitalizations, emergency department visits) at 90, 180, and 365 dayshard clinical

Home telemonitoring in heart failure provides a transient mortality benefit at 180 days but does not reduce hospitalizations and may increase emergency department visits.

Cite This Study

Pekmezaris et al. (2018) studied this question.

synapsesocial.com/papers/6a1bc65e1567d2fc4d5ef623https://doi.org/10.1377/hlthaff.2018.05087

Topics

Heart failureHFrEF treatmentHeart failure hospitalization
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Home telemonitoring for congestive heart failure: a systematic review and meta-analysis2009 · 227 citations
  2. 2Cost effectiveness of telehealth for patients with long term conditions (Whole Systems Demonstrator telehealth questionnaire study): nested economic evaluation in a pragmatic, cluster randomised controlled trial2013 · 366 citations
  3. 3Self-Care Management of Heart Failure: Practical Recommendations from the Patient Care Committee of the Heart Failure Association of the European Society of Cardiology2010 · 411 citations
  4. 4The Global Health and Economic Burden of Hospitalizations for Heart Failure2014 · 2,076 citations
  5. 5Effects of Home Telemonitoring Interventions on Patients With Chronic Heart Failure: An Overview of Systematic Reviews2015 · 353 citations