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Rivista di Medicina Interna
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,236
Minerva Medica 2016 Nov 09
The clinical effectiveness of telemedicine for chronic heart failure: a systematic review and meta-analysis
Mao H. LIN, Wo L. YUAN, Tu C. HUANG, Hai F. ZHANG, Jing T. MAI, Jing F. WANG ✉
Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P.R. China
INTRODUCTION: Telemedicine interventions had been found to effectively reduce all-cause mortality and hospital admission rate of the patients with heart failure (HF). This study aims to update the clinical benefit of telemedicine for HF.
EVIDENCE ACQUISITION: Literature databases (updated to June 30, 2016) were searched for randomized controlled trials for HF patients, in which the participants were randomized into telemedicine group (tele-transmission, telephone-supported care, and implantable monitoring) or the usual standard care group.
EVIDENCE SYNTHESIS: A total of 42 studies were included. For the telemedicine groups in general, all-cause mortality (P = 0.001), HF-related admission rate (P <0.001), HF-related length of stay (P = 0.041) were significantly lower compared with the control group. For the tele-transmission group, all-cause mortality (P=0.001), HF-related admission rate (P=0.008), HF-related length of stay (P = 0.039) and HF-related mortality (P=0.001) were significantly lower compared with the control group. For the telephone-supported care group, only HF- related admission rate (P<0.001) was significantly lower compared with the control group. Implantable monitoring group showed no significant difference in all-cause mortality compared with the control group.
CONCLUSIONS: Overall, telemedicine was shown to be beneficial in patients with heart failure. Home-based tele-transmission interventions effectively reduce all-cause mortality and HF- related hospital admission, length of stay and mortality. Telephone-supported care only show benefit in reduction of HF-related hospital admission rate.