Clinical effectiveness of telemedicine for chronic heart failure: a systematic review and meta-analysis

• Published in: Journal of investigative medicine Vol. 65; no. 5; pp. 899 - 911
• Main Authors: Lin, Mao-huan, Yuan, Wo-liang, Huang, Tu-cheng, Zhang, Hai-feng, Mai, Jing-ting, Wang, Jing-feng
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.06.2017; Sage Publications Ltd
• Subjects: Case-Control Studies; Chronic Disease; Heart Failure - mortality; Heart Failure - therapy; Hospitalization; Humans; Length of Stay; Outcome Assessment (Health Care); Patient Admission; Patient Readmission; Quality of Life; Telemedicine; Telemedicine - methods; Treatment Outcome; Heart Failure
• ISSN: 1081-5589; 1708-8267
• DOI: 10.1136/jim-2016-000199

Telemedicine interventions may be associated with reductions in hospital admission rate and mortality in patients with heart failure (HF). The present study is an updated analysis (as of June 30, 2016) of randomized controlled trials, where patients with HF underwent telemedicine care or the usual standard care. Data were extracted from 39 eligible studies for all-cause and HF-related hospital admission rate, length of stay, and mortality. The overall all-cause mortality (pooled OR=0.80, 95% CI 0.71 to 0.91, p<0.001), HF-related admission rate (pooled OR=0.63, 95% CI 0.53 to 0.76, p<0.001), and HF-related length of stay (pooled standardized difference in means=−0.37, 95% CI −0.72 to −0.02, p=0.041) were significantly lower in the telemedicine group (teletransmission and telephone-supported care), as compared with the control group. In subgroup analysis, all-cause mortality (pooled OR=0.69, 95% CI 0.56 to 0.86, p=0.001), HF-related admission rate (OR=0.61, 95% CI 0.42 to 0.88, p=0.008), HF-related length of stay (pooled standardized difference in means=−0.96, 95% CI −1.88 to −0.05, p=0.039) and HF-related mortality (OR=0.68, 95% CI 0.54 to 0.85, p=0.001) were significantly lower in the teletransmission group, as opposed to the standard care group, whereas only HF-related admission rate (OR=0.64, 95% CI 0.52 to 0.79, p<0.001) was lower in the telephone-supported care group. Overall, telemedicine was shown to be beneficial, with home-based teletransmission effectively reducing all-cause mortality and HF-related hospital admission, length of stay and mortality in patients with HF.