Remote Monitoring of Patients With Heart Failure: An Overview of Systematic Reviews

Abstract

BackgroundMany systematic reviews exist on the use of remote patient monitoring (RPM) interventions to improve clinical outcomes and psychological well-being of patients with heart failure. However, research is broadly distributed from simple telephone-based to complex technology-based interventions. The scope and focus of such evidence also vary widely, creating challenges for clinicians who seek information on the effect of RPM interventions.ObjectiveThe aim of this study was to investigate the effects of RPM interventions on the health outcomes of patients with heart failure by synthesizing review-level evidence.MethodsWe searched PubMed, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and the Cochrane Library from 2005 to 2015. We screened reviews based on relevance to RPM interventions using criteria developed for this overview. Independent authors screened, selected, and extracted information from systematic reviews. AMSTAR (Assessment of Multiple Systematic Reviews) was used to assess the methodological quality of individual reviews. We used standardized language to summarize results across reviews and to provide final statements about intervention effectiveness.ResultsA total of 19 systematic reviews met our inclusion criteria. Reviews consisted of RPM with diverse interventions such as telemonitoring, home telehealth, mobile phone–based monitoring, and videoconferencing. All-cause mortality and heart failure mortality were the most frequently reported outcomes, but others such as quality of life, rehospitalization, emergency department visits, and length of stay were also reported. Self-care and knowledge were less commonly identified.ConclusionsTelemonitoring and home telehealth appear generally effective in reducing heart failure rehospitalization and mortality. Other interventions, including the use of mobile phone–based monitoring and videoconferencing, require further investigation.

Perceptions of seniors with heart failure regarding autonomous zero-effort monitoring of physiological parameters in the smart-home environment

“…19 While technologies exist that can support remote monitoring of the physiological parameters required to manage HF (e.g., CARDIAC, MyHeart, Biotronik, CardiMems), older patients with HF may not be comfortable operating the required equipment, lack the dexterity to operate the devices, resent the intrusiveness of having devices in their home, not have the cognitive capacity or desire to take measurements on a reliable basis, and/or fail to report the results. 13,20e24 In-home monitoring of HF could be improved by circumventing these issues with "zero-effort" technology.…”

Informing the Design of “Lifestyle Monitoring” Technology for the Detection of Health Deterioration in Long-Term Conditions: A Qualitative Study of People Living With Heart Failure

“…Remote monitoring of HF typically focuses on physiological changes [54]. Utilizing technologies that measure physiological changes in parallel with LM provides opportunity to assess the respective accuracy of both data sources and adds an additional depth of information [47].…”

HerzMobil, an Integrated and Collaborative Telemonitoring-Based Disease Management Program for Patients With Heart Failure: A Feasibility Study Paving the Way to Routine Care (Preprint)

“…Telemonitoring for heart failure patients is not new and several studies have established the feasibility of these approaches and its positive impact on clinical outcome (33)(34)(35).…”