Cost-Effectiveness of Telehealth Interventions for Chronic Heart Failure Patients: A Literature Review

Grustam, Andrija S.; Severens, Johan L.; Nijnatten, Jan van; Koymans, Ron; Vrijhoef, Hubertus J. M.

doi:10.1017/s0266462313000779

Cited by 45 publications

(25 citation statements)

References 43 publications

(205 reference statements)

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“…Diabetes requires the constant monitoring of glucose levels and patient adherence to best practice recommendations, as well as engagement and participation [36]. Congestive heart failure has a high rate of hospital readmission [60].…”

Section: Discussionmentioning

confidence: 99%

“…Nine of the 51 retrieved articles reported on studies related to congestive heart failure [8][9][10]14,17,25,35,36,38]. The typical clinical parameters being measured (usually in a daily basis) were blood pressure, weight, heart rate, and oxygen saturation.…”

Section: Congestive Heart Failurementioning

confidence: 99%

“…Interactive web applications allowing the automatic transmission of monitoring information, as well as the patients entering clinical information measurements, and additional information to be reviewed by clinicians at a later time [9,14,25,36,38].…”

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confidence: 99%

“…In addition, there are studies reporting some form of health education [36], which is usually delivered by telephone calls, videoconferencing, computer-based applications, and interactive web-based applications.…”

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confidence: 99%

“…Furthermore, there are also evidence that rapid-intervention models (those where healthcare practitioners are actively involved in patient monitoring) can enhance the efficacy of remote care [38]. However, there is a difficulty in capturing all of the consequences and effects of remote care interventions in congestive heart failure, and full economic analyses of cost-effectiveness are required [36].…”

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confidence: 99%

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Remote Care Technology: A Systematic Review of Reviews and Meta-Analyses

et al. 2018

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Objectives-To identify the technologies that are being used in the remote care of patients with chronic conditions, and their most relevant outcomes. Methods-A systematic review of reviews and meta-analyses. Results-Fifty-one systematic reviews and meta-analyses related to diabetes, congestive heart failure, chronic obstructive pulmonary disease, mental and behavioral diseases, cancer, hypertension, asthma, multiple sclerosis, chronic renal disease, and obesity were retrieved; these studies compared the use of remote care technology with usual care. Conclusion-Remote care technology has positive effects in various health-related outcomes, but further research is required to allow its use in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Section: Congestive Heart Failurementioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Remote Care Technology: A Systematic Review of Reviews and Meta-Analyses

et al. 2018

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Structured telephone support or non-invasive telemonitoring for patients with heart failure

Inglis

Clark

Dierckx³

et al. 2015

Cochrane Database of Systematic Reviews

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389

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Predicting heart failure decompensation using cardiac implantable electronic devices: a review of practices and challenges

Hawkins

Virani

Sperrin

et al. 2015

European J of Heart Fail

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Cardiac implantable electronic devices include remote monitoring tools intended to guide heart failure management. The monitoring focus has been on averting hospitalizations by predicting worsening heart failure. However, although device measurements including intrathoracic impedance correlate with risk of decompensation, they individually predict hospitalizations with limited accuracy. Current ‘crisis detection’ methods involve repeatedly screening for impending decompensation, and do not adhere to the principles of diagnostic testing. Complex substrate, limited test performance, low outcome incidence, and long test to outcome times inevitably generate low positive and high negative predictive values. When combined with spectrum bias, the generalizability, incremental value, and cost‐effectiveness of device algorithms are questionable. To avoid these pitfalls, remote monitoring may need to shift from crisis detection to health maintenance, keeping the patient within an ideal physiological range through continuous ‘closed loop’ interaction and dynamic therapy adjustment. Test performance must also improve, possibly through combination with physiological sensors in different dimensions, static baseline characteristics, and biomarkers. Complex modelling may tailor monitoring to individual phenotypes, and thus realize a personalized medicine approach. Future randomized controlled trials should carefully consider these issues, and ensure that the interventions tested are generalizable to clinical practice.

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Cost-Effectiveness of Telehealth Interventions for Chronic Heart Failure Patients: A Literature Review

Cited by 45 publications

References 43 publications

Remote Care Technology: A Systematic Review of Reviews and Meta-Analyses

Remote Care Technology: A Systematic Review of Reviews and Meta-Analyses

Structured telephone support or non-invasive telemonitoring for patients with heart failure

Predicting heart failure decompensation using cardiac implantable electronic devices: a review of practices and challenges

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