Telemonitoring or structured telephone support programmes for patients with chronic heart failure: systematic review and meta-analysis
Open accessAbstract
OBJECTIVE: To determine whether remote monitoring (structured telephone support or telemonitoring) without regular clinic or home visits improves outcomes for patients with chronic heart failure. DATA SOURCES: 15 electronic databases, hand searches of previous studies, and contact with authors and experts. DATA EXTRACTION: Two investigators independently screened the results. REVIEW METHODS: Published randomised controlled trials comparing remote monitoring programmes with usual care in patients with chronic heart failure managed within the community. RESULTS: 14 randomised controlled trials (4264 patients) of remote monitoring met the inclusion criteria: four evaluated telemonitoring, nine evaluated structured telephone support, and one evaluated both. Remote monitoring programmes reduced the rates of admission to hospital for chronic heart failure by 21% (95% confidence interval 11% to 31%) and all cause mortality by 20% (8% to 31%); of the six trials evaluating health related quality of life three reported significant benefits with remote monitoring, and of the four studies examining healthcare costs with structured telephone support three reported reduced cost and one no effect. CONCLUSION: Programmes for chronic heart failure that include remote monitoring have a positive effect on clinical outcomes in community dwelling patients with chronic heart failure.
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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 [33]
Usual care varied across studies from in-person follow-up visits to a general practitioner or primary care provider to attendance at an outpatient clinic-based disease management program.
“Usual care varied across studies from in-person follow-up visits to a general practitioner or primary care provider to attendance at an outpatient clinic-based disease management program [33,34,36,37,47,49].”
From Effects of Home Telemonitoring Interventions on Patients With Chronic Heart Failure: An Overview of Systematic Reviews (2015) · cites this paper as [33]
Most reviews (8/15, 53%) did not provide sufficient details about the technology used in each of the included primary studies.
“most reviews (8/15, 53%) did not provide sufficient details about the technology used in each of the included primary studies [33,34,36-40,45-47]”
From Effects of Home Telemonitoring Interventions on Patients With Chronic Heart Failure: An Overview of Systematic Reviews (2015) · cites this paper as [33]
Of them, five pooled study results into a meta-analysis.
“Of them, five pooled study results into a meta-analysis [33-37].”
From Effects of Home Telemonitoring Interventions on Patients With Chronic Heart Failure: An Overview of Systematic Reviews (2015) · cites this paper as [33]
Similar relative and absolute risk reductions were also observed in the other two meta-analyses that achieved lower AMSTAR scores.
“Similar relative and absolute risk reductions were also observed in the other two meta-analyses that achieved lower AMSTAR scores [33,36].”
From Effects of Home Telemonitoring Interventions on Patients With Chronic Heart Failure: An Overview of Systematic Reviews (2015) · cites this paper as [33]
In most reviews, data extraction and reporting pertaining to quality of life was inadequate, since authors focused on the statistical significance of study results rather than the direction and magnitude of effect.
“In most reviews, data extraction and reporting pertaining to this outcome was inadequate, since authors focused on the statistical significance of study results rather than the direction and magnitude of effect [33-35,39,44].”
From Effects of Home Telemonitoring Interventions on Patients With Chronic Heart Failure: An Overview of Systematic Reviews (2015) · cites this paper as [33]
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- Authors
- Clark, R. A., Inglis, S. C., McAlister, F. A., Cleland, J. G. F., & Stewart, S.
- Affiliations
- University of South Australia (AU)
- The University of Queensland (AU)
- University of Alberta (CA)
- University of Hull (GB)
- Baker Heart and Diabetes Institute (AU)
- Corresponding author
- Stewart, Simon
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2007-04-10
- Volume
- 334
- Issue
- 7600
- Pages
- 942
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC1865411
- OpenAlex
- W1985760052
- Cited by
- 672
- References
- 37
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 13 · 2023: 25 · 2022: 15 · 2021: 28 · 2020: 22 · 2019: 17 · 2018: 30 · 2017: 46 · 2016: 42 · 2015: 53 · 2014: 51 · 2013: 55 · 2012: 45
- FWCI
- 7.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- QUT ePrints (Queensland University of Technology) (submittedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- OPUS - Open Publications of UTS Scholars (University of Technology Sydney) (submittedVersion)
- Funders
- University of Alberta
- European Commission
- National Heart Foundation of Australia
- National Institute of Clinical Studies
- University of South Australia
- Fondation pour la Recherche Médicale
- Canadian Institutes of Health Research
- Medical Research Council
- National Health and Medical Research Council
- 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
- chronic heart failure, remote patient monitoring, remote monitoring, hospital readmission, all-cause mortality, health-related quality of life, health care costs, community-dwelling patients, usual care
- MeSH terms
- Chronic Disease, Heart Failure, Hospitalization, Humans, Telephone, Randomized Controlled Trials as Topic, Treatment Outcome, Remote Consultation
About these checks
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.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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