Telemonitoring in heart failure patients:Systematic review and metaanalysis of randomized controlled trials  

作　　者：Chukwuemeka Anthony Umeh Adrian Torbela Shipra Saigal Harpreet Kaur Shadi Kazourra Rahul Gupta Shivang Shah 

机构地区：[1]Internal Medicine,Hemet Global Medical Center,Hemet,CA 92543,United States [2]Department of Cardiology,Loma Linda University School of Medicine,Loma Linda,CA 92350,United States [3]Department of Cardiology,University of California Riverside School of Medicine,Riverside,CA 92507,United States

出　　处：《World Journal of Cardiology》2022年第12期640-656,共17页世界心脏病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Home telemonitoring has been used as a modality to prevent readmission and improve outcomes for patients with heart failure.However,studies have produced conflicting outcomes over the years.AIM To determine the aggregate effect of telemonitoring on all-cause mortality,heart failure-related mortality,all-cause hospitalization,and heart failure-related hospitalization in heart failure patients.METHODS We conducted a systematic review and meta-analysis of 38 home telemonitoring randomized controlled trials involving 14993 patients.We also conducted a sensitivity analysis to examine the effect of telemonitoring duration,recent heart failure hospitalization,and age on telemonitoring outcomes.RESULTS Our study demonstrated that home telemonitoring in heart failure patients was associated with reduced all-cause[relative risk(RR)=0.83,95% confidence interval(CI):0.75-0.92,P=0.001]and cardiovascular mortality(RR=0.66,95%CI:0.54-0.81,P<0.001).Additionally,telemonitoring decreased the all-cause hospitalization(RR=0.87,95%CI:0.80-0.94,P=0.002)but did not decrease heart failurerelated hospitalization(RR=0.88,95%CI:0.77-1.01,P=0.066).However,prolonged home telemonitoring(12 mo or more)was associated with both decreased all-cause and heart failure hospitalization,unlike shorter duration(6 mo or less)telemonitoring.CONCLUSION Home telemonitoring using digital/broadband/satellite/wireless or blue-tooth transmission of physiological data reduces all-cause and cardiovascular mortality in heart failure patients.In addition,prolonged telemonitoring(≥12 mo)reduces all-cause and heart failure-related hospitalization.The implication for practice is that hospitals considering telemonitoring to reduce heart failure readmission rates may need to plan for prolonged telemonitoring to see the effect they are looking for.

关 键 词：TELEMONITORING Heart failure TELEHEALTH Home monitoring Remote monitoring 

分 类 号：R541.6[医药卫生—心血管疾病]