Evaluating the Evidence Base for the Use of Home Telehealth Remote Monitoring in Elderly with Heart Failure
Abstract
Information and communication technology offers promise for better coordination of care for patients with congestive heart failure (CHF). MEDLINE, EMBASE, and CINHAL databases were searched for evidence on remote monitoring of patients with heart failure (HF). The search was restricted to randomized controlled trials using either automated monitoring of signs and symptoms or automated physiologic monitoring. For this review, telephone-based monitoring of signs and symptoms was not considered remote monitoring. Studies were also excluded if they did not present outcomes related to healthcare utilization. Nine studies met selection criteria, with interventions that varied greatly. Four three-arm studies directly compared the effectiveness of two different interventions to usual care. Six of the nine studies suggested a 27%-40% reduction in overall admissions. Two two-arm studies demonstrated a 40%-46% reduction in HF-related admissions while two other three-arm studies showed similar trends; however, this was not statistically significant. Three of nine studies suggested a significant reduction in mortality (30%-67%) and three studies showed significant reduction in healthcare utilization costs. Two studies suggested a 53%-62% reduction in bed days of care. Two studies showed significant reduction in the number of Emergency Department visits. Three two-arm studies and one three-arm study demonstrated significant overall improvement in outcomes with use of telemonitoring. Available data suggest that telemonitoring is a promising strategy. More data are needed to determine the ideal patient population, technology, and parameters, frequency and duration of telemonitoring, and the exact combination of case management and close monitoring that would assure consistent and improved outcomes with cost reductions in HF.
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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 [43]
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 [43]
The remaining systematic reviews reached different conclusions about the impact of HT on length of stay.
“However, the remaining systematic reviews reached different conclusions [35,39,40,43,45].”
From Effects of Home Telemonitoring Interventions on Patients With Chronic Heart Failure: An Overview of Systematic Reviews (2015) · cites this paper as [43]
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 [43]
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- Authors
- Dang, S., Dimmick, S., & Kelkar, G.
- Affiliations
- University of Miami (US)
- University of Tennessee at Knoxville (US)
- Bruce W. Carter VA Medical Center (US)
- ORCID
- Dang, Stuti
- Venue
- Telemedicine and e-Health
- Publisher
- SAGE Publications
- Published
- 2009-10
- Volume
- 15
- Issue
- 8
- Pages
- 783-796
- ISSN
- 1530-5627 (ISSN-L)
- 1556-3669
- OpenAlex
- W2153816875
- Cited by
- 121
- References
- 44
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 6 · 2023: 3 · 2022: 12 · 2021: 6 · 2020: 8 · 2019: 3 · 2018: 12 · 2017: 8 · 2016: 5 · 2015: 13 · 2014: 6 · 2013: 9 · 2012: 8
- FWCI
- 8.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Telemedicine Journal and e-Health (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- congestive heart failure, remote monitoring, home telehealth, elderly patients, hospital readmission, health care utilization, mortality reduction, emergency department visits, health care costs, case management
- MeSH terms
- Aged, Aged, 80 and over, Heart Failure, Home Care Services, Humans, Monitoring, Physiologic, Case Management, Remote Consultation
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