Effects of Different Telemonitoring Strategies on Chronic Heart Failure Care: Systematic Review and Subgroup Meta-Analysis

被引：36

作者：

Ding, Hang ^{[1
,2
,3
]}

Chen, Sheau Huey ^{[4
]}

Edwards, Iain ^{[5
]}

Jayasena, Rajiv ^{[6
]}

Doecke, James ^{[6
]}

Layland, Jamie ^{[7
,8
]}

Yang, Ian A. ^{[9
]}

Maiorana, Andrew ^{[4
,10
,11
]}

机构：

[1] Univ Queensland, Fac Hlth & Behav Sci, RECOVER Injury Res Ctr, Brisbane, Qld, Australia

[2] CSIRO, Australian E Hlth Res Ctr, Brisbane, Qld, Australia

[3] Univ Queensland, Prince Charles Hosp, Northside Clin Unit Sch, Fac Med, Brisbane, Qld, Australia

[4] Curtin Univ, Sch Physiotherapy & Exercise Sci, GPO Box U1987, Perth, WA 6845, Australia

[5] Peninsula Hlth, Dept Community Hlth, Melbourne, Vic, Australia

[6] CSIRO, Australian E Hlth Res Ctr, Melbourne, Vic, Australia

[7] Peninsula Hlth, Dept Cardiol, Melbourne, Vic, Australia

[8] Monash Univ, Peninsula Clin Sch, Melbourne, Vic, Australia

[9] Univ Queensland, Prince Charles Hosp, Dept Thorac Med, Brisbane, Qld, Australia

[10] Fiona Stanley Hosp, Allied Hlth Dept, Perth, WA, Australia

[11] Fiona Stanley Hosp, Adv Heart Failure & Cardiac Transplant Serv, Perth, WA, Australia

来源：

JOURNAL OF MEDICAL INTERNET RESEARCH | 2020年 / 22卷 / 11期

关键词：

telehealth; telemonitoring; mobile health; chronic heart failure; systematic review; meta-analysis; RANDOMIZED CLINICAL-TRIAL; QUALITY-OF-LIFE; DISEASE MANAGEMENT; HEALTH-CARE; MONITORING-SYSTEM; MOBILE HEALTH; SELF-CARE; HOME; HOSPITALIZATION; MORTALITY;

D O I：

10.2196/20032

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Background: Telemonitoring studies in chronic heart failure are characterized by mixed mortality and hospitalization outcomes, which have deterred the uptake of telemonitoring in clinical practice. These mixed outcomes may reflect the diverse range of patient management strategies incorporated in telemonitoring. To address this, we compared the effects of different telemonitoring strategies on clinical outcomes. Objective: The aim of this systematic review and subgroup meta-analysis was to identify noninvasive telemonitoring strategies attributing to improvements in all-cause mortality or hospitalization outcomes for patients with chronic heart failure. Methods: We reviewed and analyzed telemonitoring strategies from randomized controlled trials (RCTs) comparing telemonitoring intervention with usual care. For each strategy, we examined whether RCTs that applied the strategy in the telemonitoring intervention (subgroup 1) resulted in a significantly lower risk ratio (RR) of all-cause mortality or incidence rate ratio (IRR) of all-cause hospitalization compared with RCTs that did not apply this strategy (subgroup 2). Results: We included 26 RCTs (N=11,450) incorporating 18 different telemonitoring strategies. RCTs that provided medication support were found to be associated with a significantly lower IRR value than RCTs that did not provide this type of support (P=.01; subgroup 1 IRR=0.83, 95% CI 0.72-0.95 vs subgroup 2 IRR=1.02, 95% CI 0.93-1.12). RCTs that applied mobile health were associated with a significantly lower IRR (P=.03; IRR=0.79, 95% CI 0.64-0.96 vs IRR=1.00, 95% CI 0.94-1.06) and RR (P=.01; RR=0.67, 95% CI 0.53-0.85 vs RR=0.95, 95% CI 0.84-1.07). Conclusions: Telemonitoring strategies involving medication support and mobile health were associated with improvements in all-cause mortality or hospitalization outcomes. These strategies should be prioritized in telemonitoring interventions for the management of patients with chronic heart failure.

引用

页数：20

共 77 条

[1] A Grassroots Remote Sensing Toolkit Using Live Coding, Smartphones, Kites and Lightweight Drones [J].