Effectiveness of Non-Invasive Home Telemonitoring in Outpatient Care for Patients with Heart Failure: A Systematic Review

Abstract

Introduction: The role of non-invasive home telemonitoring (NIHT) in the treatment of patients with heart failure (HF) is all but established. Field specialists are left in disagreement and the literature is conflicting. However it remains unclear if recent technological advances have empowered NIHT sufficiently to affirm a position in the management of HF. Our aim was to systematically review the evidence about the efficacy of this intervention. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials on the effect of NIHT on the treatment of HF, in regards to the mortality, hospitalizations and quality of life. We searched four electronic databases up to September 2017 without language restrictions, reviewed references of relevant articles and contacted experts. Results: Of 1362 articles identified, 18 were included. NIHT reduced all-cause mortality (OR 0.81, 95% CI 0.68 to 0.98; participants = 4426; studies = 16; I2 = 20%) and heart failure-related hospitalizations (OR 0.66, 95% CI 0.54 to 0.82; participants = 1954; studies = 10; I2 = 45%). NIHT failed to demonstrate effectiveness in reducing either all-cause hospitalizations (OR 1.08, 95% CI 0.94 to 1.24; participants = 3702; studies = 10; I2 = 39%) or CV-mortality (OR 0.71, 95% CI 0.49 to 1.05; participants = 1386; studies = 6; I2 = 0%). Conclusion: Randomized controlled trials support the use of NIHT as a strategy to reduce cardiovascular hospitalizations and mortality in patients with HF.