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Health Aff (Millwood). 2018 Dec;37(12):1983-1989. doi: 10.1377/hlthaff.2018.05087.

Home Telemonitoring In Heart Failure: A Systematic Review And Meta-Analysis.

Author information

1
Renee Pekmezaris is vice president of the Division of Health Services Research and a professor in the Departments of Medicine and Population Health, Northwell Health, in Manhasset, New York.
2
Leanne Tortez is a research assistant in the Department of Medicine, Northwell Health, in Manhasset.
3
Myia Williams ( mwilliam26@northwell.edu ) is a research assistant in the Department of Medicine, Northwell Health, in Manhasset.
4
Vidhi Patel is a research assistant in the Department of Medicine, Northwell Health, in Manhasset.
5
Amgad Makaryus is chair of the Department of Cardiology, Nassau University Medical Center, in East Meadow, New York, and a cardiologist in the Department of Cardiology, Northwell Health, in Manhasset.
6
Roman Zeltser is a cardiologist in the Department of Cardiology, Nassau University Medical Center, and a cardiologist in the Department of Cardiology, Northwell Health, in Manhasset.
7
Liron Sinvani is a physician in the Department of Medicine, Northwell Health, in Great Neck, New York.
8
Gisele Wolf-Klein is a physician in the Department of Medicine, Division of Geriatrics and Palliative Care, Northwell Health, in New Hyde Park, New York.
9
Janice Lester is a health sciences librarian in the Clinical Medical Library, Northwell Health, in New Hyde Park.
10
Cristina Sison is assistant director in the Department of Biostatistics, Feinstein Institute for Medical Research, in Manhasset.
11
Martin Lesser is assistant vice president in the Department of Biostatistics, Feinstein Institute for Medical Research.
12
Andrzej Kozikowski is a senior analyst in the Division of Health Services Research and an assistant professor in the Department of Medicine, Northwell Health, in Manhasset.

Abstract

We conducted a meta-analysis of twenty-six randomized controlled trials that tested the effectiveness of home telemonitoring in patients with heart failure for reducing mortality and hospital use. We used the PICOT framework as a tool to address an important variable not previously studied: the timing or duration of monitoring. Specifically, we found that home telemonitoring decreased the odds of all-cause mortality and heart failure-related mortality at 180 days but not at 365 days. Home telemonitoring did not significantly affect the odds of all-cause hospitalization at 90 or 180 days, or of heart failure-related hospitalization at 180 days. At 180 days, home telemonitoring significantly increased the odds of all-cause emergency department visits. Home care provision did not moderate the effects of home telemonitoring on all-cause hospitalization. Recent regulatory changes that relaxed Medicare restrictions on telehealth reimbursement make it imperative that studies fully describe outcomes (for example, heart failure-related versus all-cause hospitalizations) and deliberately test all essential intervention elements, such as intervention duration.

PMID:
30633680
DOI:
10.1377/hlthaff.2018.05087

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