Telemonitoring in patients with heart failure
Open accessAbstract
BACKGROUND: Small studies suggest that telemonitoring may improve heart-failure outcomes, but its effect in a large trial has not been established. METHODS: We randomly assigned 1653 patients who had recently been hospitalized for heart failure to undergo either telemonitoring (826 patients) or usual care (827 patients). Telemonitoring was accomplished by means of a telephone-based interactive voice-response system that collected daily information about symptoms and weight that was reviewed by the patients' clinicians. The primary end point was readmission for any reason or death from any cause within 180 days after enrollment. Secondary end points included hospitalization for heart failure, number of days in the hospital, and number of hospitalizations. RESULTS: The median age of the patients was 61 years; 42.0% were female, and 39.0% were black. The telemonitoring group and the usual-care group did not differ significantly with respect to the primary end point, which occurred in 52.3% and 51.5% of patients, respectively (difference, 0.8 percentage points; 95% confidence interval [CI], -4.0 to 5.6; P=0.75 by the chi-square test). Readmission for any reason occurred in 49.3% of patients in the telemonitoring group and 47.4% of patients in the usual-care group (difference, 1.9 percentage points; 95% CI, -3.0 to 6.7; P=0.45 by the chi-square test). Death occurred in 11.1% of the telemonitoring group and 11.4% of the usual care group (difference, -0.2 percentage points; 95% CI, -3.3 to 2.8; P=0.88 by the chi-square test). There were no significant differences between the two groups with respect to the secondary end points or the time to the primary end point or its components. No adverse events were reported. CONCLUSIONS: Among patients recently hospitalized for heart failure, telemonitoring did not improve outcomes. The results indicate the importance of a thorough, independent evaluation of disease-management strategies before their adoption. (Funded by the National Heart, Lung, and Blood Institute; ClinicalTrials.gov number, NCT00303212.).
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Many studies took place with enthusiastic supporters using home-grown technologies and the observed benefits may not therefore be replicable in other contexts, or when scaled-up for routine settings.
“Many studies took place with enthusiastic supporters using home-grown technologies and the observed benefits may not therefore be replicable in other contexts, or when scaled-up for use in routine settings [105], [106], [107], [108].”
From The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview (2013) · cites this paper as [106]
The Discussion says a previous small, single-site trial relied on a highly motivated nurse using an intervention developed by the investigative team, limiting the generalizability and scalability of its benefits. It does not establish that many studies used home-grown technologies under those conditions. Page numbers are not provided in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredAnother large US trial found no difference in hospital readmissions or deaths at six months between interactive voice response telemonitoring and usual care in heart failure.
“There was no difference in hospital readmissions or deaths in the groups at six months [106].”
From The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview (2013) · cites this paper as [106]
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- Authors
- Chaudhry, S. I., Mattera, J. A., Curtis, J. P., Spertus, J. A., Herrin, J., Lin, Z., Phillips, C. O., Hodshon, B. V., Cooper, L. S., & Krumholz, H. M.
- Affiliations
- Yale University (US)
- Yale New Haven Hospital (US)
- Saint Luke's Health System (US)
- Morehouse School of Medicine (US)
- National Heart, Lung, and Blood Institute (US)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2010-12-09
- Volume
- 363
- Issue
- 24
- Pages
- 2301-2309
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC3237394
- OpenAlex
- W2016468586
- Cited by
- 1,232
- References
- 18
- Citations by year
- 2026: 31 · 2025: 44 · 2024: 53 · 2023: 56 · 2022: 58 · 2021: 92 · 2020: 79 · 2019: 57 · 2018: 82 · 2017: 97 · 2016: 92 · 2015: 108 · 2014: 107 · 2013: 99 · 2012: 88
- FWCI
- 59.93
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- 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, heart failure, hospital readmission, mortality, heart failure hospitalization, symptom monitoring, weight monitoring, disease management strategies
- MeSH terms
- Aged, Female, Heart Failure, Home Care Services, Hospitalization, Humans, Male, Middle Aged, Monitoring, Physiologic, Patient Readmission, Severity of Illness Index, Telemedicine, Kaplan-Meier Estimate
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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