A meta-analysis of remote patient monitoring for chronic heart failure patients

Abstract

We carried out a meta analysis of remote patient monitoring (RPM) for chronic heart failure (CHF) patients. A literature search was used to identify randomised controlled trials with more than 40 patients, published between February 2003 and February 2013. The primary outcome (mortality) was analysed using a random effect model. Thirteen studies were included (3337 patients). RPM resulted in a significantly lower mortality (risk ratio 0.76; 95% confidence interval 0.62 to 0.93) compared to usual care. The test for heterogeneity showed that articles had been extracted homogeneously (I(2)=0%, P=0.67). In order to determine which RPM model was most effective, subgroup analyses were conducted by age, severity of illness, measurement frequency, medication management and speed of intervention. The group with rapid intervention had the lowest mortality (rapid group risk ratio=0.59, non-rapid group risk ratio=0.88, P=0.05). The group with high measurement frequency had lower mortality (high frequency group risk ratio=0.62, low frequency group risk ratio=0.89, P=0.07). The group with medication management had lower mortality (medication group risk ratio=0.65, non medication group risk ratio=0.85, P=0.19). RPM is effective in chronic heart failure and rapid intervention was the most important factor in the RPM model.

A multimodal technology intervention for heart failure patients to reduce readmissions

“…These findings are consistent with multiple studies that also reported successful incorporation of HT with HF study participants in order to promote self-care resulting in both reductions and/or absences of hospital readmissions. [27][28][29][30][31][32] Patients in the HT Group A reported higher levels of being able to manage their HF self-care over time in contrast to participants in Groups B and C. This behavior specifically refers to the decision-making process in which patients recognize and respond to their symptoms. Self-care management is an active, deliberative process that is essential in HF self-care if patients are going to control the balance between relative health and symptomatic HF.…”

Developing a Sensor based Homecare System - The Role of Bluetooth Low-Energy in Activity Monitoring

“…Research into intelligent healthcare solutions for this problem is however limited by the technology itself. Although sensors used in RPM have proven to be successful (Nakamura et al, 2013), activity and lifestyle monitoring has become an issue while using occupancy technologies such as PIR sensors, door sensors and chair sensors. There is also a large gap in the ability to provide monitoring for elderly who suffer from dehydration and malnourishment, a significant attributor to NCDs and death in that age group .…”

“…Nakamura et al has demonstrated the efficacy of this method of remote, technology assisted care by examining the effectiveness of RPM in reducing the risk of mortality for CHF patients compared to 'usual care' (Nakamura et al, 2013. A significant factor in reducing mortality when using RPM has been the higher frequency of measurements from the patient as this allows for a greater amount of data to be examined and thus an intervention made timelier.…”

“…RPM appears to be an effaceable approach to delivering intelligent healthcare, by capturing data reportedly and analysing it using medical models it can be possible to predict, prevent and manage illness without the need of hospital or nurse visits to collect this data. Clinical effectiveness of patients submitting frequent clinical measurements from the home environment to allow a greater spectrum of data points (Nakamura et al, 2013) is a clear factor in the success of the technology and the patients outcomes. However, NCDs often have a wider variety of care requirements, where CHF can be measured remotely using a simple heart or pulse monitor, NCDs have a wide variety of ailments and symptoms associated with their acceleration.…”

A Systematic Review of Literature Reporting on Studies Analysing Technologies for Ageing in Place to Support Community-Dwelling Older Adults

“…• Congestive heart failure -Automatic patient data transmission by means of monitoring devices is being used together with standard telephone calls to allow the assessment of symptoms and vital signs, as well as the transmission of automatic alarms (Conway, Inglis and Clark, 2014;Nakamura, Koga and Iseki, 2014) targeting older adults with congestive heart failure. Home monitoring is used mainly to minimize heart failure-related hospitalizations and all-cause mortality (Conway et al, 2014) when compared with usual care, but several secondary outcomes are also considered, such as self-care behaviour (e.g.…”