Telemonitoring for Patients With Chronic Heart Failure: A Systematic Review
Open accessAbstract
Background Telemonitoring, the use of communication technology to remotely monitor health status, is an appealing strategy for improving disease management.Methods and results We searched Medline databases, bibliographies, and spoke with experts to review the evidence on telemonitoring in heart failure patients. Interventions included: telephone-based symptom monitoring (n = 5), automated monitoring of signs and symptoms (n = 1), and automated physiologic monitoring (n = 1). Two studies directly compared effectiveness of 2 or more forms of telemonitoring. Study quality and intervention type varied considerably. Six studies suggested reduction in all-cause and heart failure hospitalizations (14% to 55% and 29% to 43%, respectively) or mortality (40% to 56%) with telemonitoring. Of the 3 negative studies, 2 enrolled low-risk patients and patients with access to high quality care, whereas 1 enrolled a very high-risk Hispanic population. Studies comparing forms of telemonitoring demonstrated similar effectiveness. However, intervention costs were higher with more complex programs (8383 dollars per patient per year) versus less complex programs (1695 dollars per patient per year).Conclusion The evidence base for telemonitoring in heart failure is currently quite limited. Based on the available data, telemonitoring may be an effective strategy for disease management in high-risk heart failure patients.
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Nine reviews analyzed telehealth interventions for heart failure.
“A total of 9 reviews analyzed telehealth interventions for heart failure [16,20,28,55-60].”
A 2-star narrative review showed no mortality benefit from telephone-only interventions and a variable effect on hospital admissions.
“In contrast, a 2-star narrative review showed no mortality benefit from telephone-only interventions and a variable effect on hospital admissions [55].”
For type 2 diabetes and heart failure, findings were inconsistent between reviews, and analyses of similar interventions reached different conclusions.
“For both of these conditions, however, findings were inconsistent between reviews, and analyses of similar interventions reached different conclusions [25,55,57].”
The majority of systematic reviews (10/15, 67%) summarized and reported relevant information about the type of physiological measures monitored in the included trials.
“While the majority of systematic reviews (10/15, 67%) summarized and reported relevant information about the type of physiological measures monitored in the included trials [33,34,37,38,41-44,47,49]”
From Effects of Home Telemonitoring Interventions on Patients With Chronic Heart Failure: An Overview of Systematic Reviews (2015) · cites this paper as [41]
Out of the 15 systematic reviews, only two classified and analyzed HT interventions according to the technologies used.
“Also, out of the 15 systematic reviews, only two classified and analyzed HT interventions according to the technologies used [41,44].”
From Effects of Home Telemonitoring Interventions on Patients With Chronic Heart Failure: An Overview of Systematic Reviews (2015) · cites this paper as [41]
The remaining six summarized the available evidence narratively using various qualitative or semi-quantitative techniques.
“The remaining six summarized the available evidence narratively using various qualitative or semi-quantitative techniques [38,39,41,43,45].”
From Effects of Home Telemonitoring Interventions on Patients With Chronic Heart Failure: An Overview of Systematic Reviews (2015) · cites this paper as [41]
Eight reviews concurred that the impact of HT interventions on health care costs appeared to be positive in more cases than not, but in general results were statistically inconclusive and varied depending on the context and specific national health system of the study.
“Eight reviews concurred that the impact of HT interventions on health care costs appeared to be positive in more cases than not, but in general results were statistically inconclusive and varied depending on the context and specific national health system of the study [34,36,38,39,41,43,44,47].”
From Effects of Home Telemonitoring Interventions on Patients With Chronic Heart Failure: An Overview of Systematic Reviews (2015) · cites this paper as [41]
Health care professionals are often skeptical and show little support for eHealth because technology does not seem to work for them or the benefit of their patients.
“Health care professionals are often skeptical and show little support for eHealth because technology does not seem to work for them or the benefit of their patients [5].”
From A Holistic Framework to Improve the Uptake and Impact of eHealth Technologies (2011) · cites this paper as [5]
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- Authors
- Chaudhry, S. I., Phillips, C. O., Stewart, S. S., Riegel, B., Mattera, J. A., Jerant, A. F., & Krumholz, H. M.
- Affiliations
- Yale University (US)
- Cleveland Clinic Lerner College of Medicine (US)
- Baker Heart and Diabetes Institute (AU)
- University of Pennsylvania (US)
- Yale New Haven Hospital (US)
- University of California, Davis (US)
- Venue
- Journal of Cardiac Failure
- Publisher
- Elsevier BV
- Published
- 2007-02
- Volume
- 13
- Issue
- 1
- Pages
- 56-62
- ISSN
- 1071-9164 (ISSN-L)
- PMC
- PMC1910700
- OpenAlex
- W2001025430
- Cited by
- 231
- References
- 24
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 6 · 2023: 8 · 2022: 7 · 2021: 14 · 2020: 4 · 2019: 5 · 2018: 17 · 2017: 20 · 2016: 15 · 2015: 15 · 2014: 15 · 2013: 16 · 2012: 12
- FWCI
- 2.85
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Cardiac Failure (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- ScholarlyCommons (University of Pennsylvania) (submittedVersion)
- Research Bank (Australian Catholic University) (submittedVersion)
- Funders
- National Institute on Aging (K23AG030986)
- National Heart, Lung, and Blood Institute (R01HL080228)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- remote patient monitoring, chronic heart failure, heart failure hospitalization, mortality, intervention costs, high-risk patients, Hispanic patients
- MeSH terms
- Aged, Chronic Disease, Female, Heart Failure, Humans, Male, Middle Aged, Monitoring, Physiologic, Randomized Controlled Trials as Topic, Telemedicine
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