Bertram Pitt, MD
Is remote patient monitoring (RPM) effective for management of patients with heart failure?
Included studies assessed the effects of RPM in patients with chronic heart failure and included a control group. Outcomes were all-cause mortality, first hospitalization for any cause, first hospitalization for heart failure, and a combined endpoint of first hospitalization for any cause and all-cause mortality.
PubMed, EMBASE/Excerpta Medica, CINAHL, Cochrane Library, and the National Guideline Clearinghouse were searched for full-text articles of randomized controlled trials (RCTs) or cohort studies published in peer-reviewed journals from 2000 to October 2008 in English, Spanish, German, French, or Italian. 20 RCTs (median age 70 y, 64% men) and 12 cohort studies met the selection criteria. Only the results of RCTs are reported here; 10 RCTs were considered high quality (≥ 8 out of 10 on an 11-point visual analogue scale). RPM comprised telephone monitoring (regularly scheduled contact and reporting of symptoms and/or physiologic data) or technology-assisted monitoring (information communication technology, with transfer of physiologic data collected by remote external monitors or implanted electronic devices). Usual care comprised in-person patient visits without additional phone calls to and from patients.
Meta-analysis showed that RPM reduced risk for all-cause mortality, first hospitalization for heart failure, and the combined endpoint of first hospitalization for any cause and all-cause mortality (Table). Although fixed-effect meta-analysis showed that RPM reduced first hospitalizations for any cause, significance disappeared when a random-effects model was used (Table).
Remote patient monitoring of patients with heart failure reduces mortality and hospitalization for heart failure compared with usual care.
Remote patient monitoring (RPM) vs usual care for management of patients with heart failure (HF)*
*NR = not reported; other abbreviations defined in Glossary. RRR, NNT, and CI calculated from data in article using a fixed-effect model.
†Based on a random-effects model
Bertram Pitt. Review: Remote patient monitoring of patients with heart failure reduces mortality and heart failure admissions. Ann Intern Med. 2010;152:JC4–3. doi: 10.7326/0003-4819-152-8-201004200-02003
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Published: Ann Intern Med. 2010;152(8):JC4-3.
Cardiology, Heart Failure.
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