Telehealth interventions reduced all-cause mortality by 20% (RR 0.80) compared to usual care in patients with heart failure across 41 randomized controlled trials.
Systematic Review (n=3,740)
Do telehealth interventions improve clinical outcomes and equitable access to care in older adults with heart failure?
Telehealth has the potential to improve outcomes and access to care for older adults with heart failure, but achieving digital health equity requires addressing multilevel structural, organizational, and personal barriers.
Effect estimate: RR 0.80 (95% CI 0.68-0.94)
p-value: p=0.006
Enhancing access to care using telehealth is a priority for improving outcomes among older adults with heart failure, increasing quality of care, and decreasing costs. Telehealth has the potential to increase access to care for patients who live in underresourced geographic regions, have physical disabilities or poor access to transportation, and may not otherwise have access to cardiologists with expertise in heart failure. During the COVID-19 pandemic, access to telehealth expanded, and yet barriers to access, including broadband inequality, low digital literacy, and structural barriers, prevented many of the disadvantaged patients from getting equitable access. Using a health equity lens, this scientific statement reviews the literature on telehealth for older adults with heart failure; provides an overview of structural, organizational, and personal barriers to telehealth; and presents novel interventions that pair telemedicine with in-person services to mitigate existing barriers and structural inequities.
Creber et al. (2023) conducted a systematic review in Heart Failure (n=3,740). Telehealth interventions vs. Usual care was evaluated on All-cause mortality (RR 0.80, 95% CI 0.68-0.94, p=0.006). Telehealth interventions reduced all-cause mortality by 20% (RR 0.80) compared to usual care in patients with heart failure across 41 randomized controlled trials.