Telemonitoring in primary care management of cardiovascular disease is associated with significant reductions in blood pressure, decreased hospitalizations, and reduced all-cause mortality.
Systematic Review
Does telemonitoring improve clinical outcomes and reduce costs in patients with cardiovascular disease, heart failure, or hypertension managed in primary care?
Telemonitoring in primary care for cardiovascular disease, including heart failure and hypertension, improves clinical outcomes such as mortality and hospitalizations while reducing healthcare costs.
BACKGROUND: There has been growing interest regarding the impact of telemonitoring and its ability to reduce the increasing burden of chronic diseases, including chronic cardiovascular disease (CVD), on healthcare systems. A number of randomised trials have been undertaken internationally and synthesised into various systematic reviews to establish an evidence base for this model of care. This study sought to synthesise and critically evaluate this large body of evidence to inform clinicians, researchers and policy makers. METHODS: A systematic review of systematic reviews investigating the impact of telemonitoring interventions in the primary care management of CVD was conducted. Reviews were included if they explored primary care based telemonitoring in either CVD, heart failure or hypertension, were reported in the English language and were published between 2000 and 2013. Data was extracted by one reviewer and checked by a second reviewer using a standardised form. Two assessors then rated the quality of each review using the Overview Quality Assessment Questionnaire (OQAQ). RESULTS: Of the 13 included reviews, four focused on telemonitoring interventions in hypertension or CVD management and the remaining 9 reviews investigated telemonitoring in HF management. Seven reviews scored a five or above on the OQAQ evidencing good quality reviews. Findings suggest that telemonitoring can contribute to significant reductions in blood pressure, decreased all-cause and HF related hospitalisations, reduced all-cause mortality and improved quality of life. Telemonitoring was also demonstrated to reduce health care costs and appears acceptable to patients. CONCLUSION: Telemonitoring has the potential to enhance primary care management of CVD by improving patient outcomes and reducing health costs. However, further research needs to explore the specific elements of telemonitoring interventions to determine the relative value of the various elements. Additionally, the ways in which telemonitoring care improves health outcomes needs to be further explored to understand the nature of these interventions.
Purcell et al. (Fri,) conducted a systematic review in Cardiovascular disease, heart failure, and hypertension. Telemonitoring vs. Usual care or clinic-based monitoring was evaluated. Telemonitoring in primary care management of cardiovascular disease is associated with significant reductions in blood pressure, decreased hospitalizations, and reduced all-cause mortality.