Researchers at the Baker IDI Heart and Diabetes Institute (Melbourne, VIC, Australia) reviewed randomized controlled trials (RCTs) of structured telephone support or telemonitoring support of CHF patients, compared to standard practice, in order to quantify the effects of these interventions. The researchers reviewed, among others, The Cochrane Library, MEDLINE, EMBASE, as well as various search engines to update a previously published non-Cochrane review. The bibliographies of relevant studies and systematic reviews and abstract conference proceedings were hand-searched, and no language limits were applied. Primary outcomes included all-cause mortality and all-cause and CHF-related hospitalizations, which were meta-analyzed using fixed effects models. Other outcomes included length of stay, quality of life, and acceptability and cost. In all, 25 studies and 5 published abstracts were included; of these, 16 evaluated structured telephone support (with 5,613 participants), 11 evaluated telemonitoring (2,710 participants), and 2 tested both interventions.

The results showed that telemonitoring reduced all-cause mortality with structured telephone support demonstrating a nonsignificant positive effect. Both structured telephone support and telemonitoring reduced CHF-related hospitalizations, but no significant benefit was seen with structured telephone support on mortality. Both structured telephone support and telemonitoring significantly reduced the number of patients who were admitted to hospital due to worsening of heart failure, which occurred at a rate of 164 per 1,000 with structured telephone support, compared to 213 in a control group, and at a rate of 225 per 1,000 with telemonitoring compared to 285 in a control group. For both interventions, several studies showed improved quality of life, reduced healthcare costs, and were acceptable to patients. The study was published in the August 4, 2010, issue of the Cochrane Database of Systematic Reviews.

"Structured telephone support and telemonitoring are effective in reducing the risk of all-cause mortality and CHF-related hospitalizations in patients with CHF; they improve quality of life, reduce costs, and evidence-based prescribing,” said lead author Sally Inglis, M.D. "These technologies can provide specialized care to a large number of patients who otherwise may have limited access to this type of specialized healthcare.”

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Baker IDI Heart and Diabetes Institute