Remote patient monitoring in heart failure: A comprehensive meta-analysis of effective programme components for hospitalization and mortality reduction

IF 10.8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS European Journal of Heart Failure Pub Date : 2025-01-20 DOI:10.1002/ejhf.3568

Ignace L.J. De Lathauwer, Wessel W. Nieuwenhuys, Frederique Hafkamp, Marta Regis, Rutger W.M. Brouwers, Mathias Funk, Hareld M.C. Kemps

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Abstract

Aims

Methods of non-invasive remote patient monitoring (RPM) for heart failure (HF) remain diverse. Understanding factors that influence the effectiveness of RPM on HF-related and all-cause hospitalizations, mortality, and emergency department visits is crucial for developing successful RPM interventions. This meta-analysis aims to synthesize and compare existing literature on RPM components that impact HF-related and all-cause hospitalizations, mortality and emergency department visits in HF patients.

Methods and results

A systematic search of electronic databases (PubMed, EMBASE, CENTRAL) identified randomized controlled trials from January 2012 to June 2023, comparing non-invasive RPM interventions for HF with usual care. A random-effects meta-analysis assessed outcomes, and additional analyses identified effective RPM components. A total of 41 studies with 16 312 patients (mean follow-up: 9.88 ± 6.37 months) were included. RPM was associated with lower mortality risk (pooled odds ratio [OR] 0.81 95% confidence interval [CI] 0.69–0.95; I² = 0.39) and reduced first HF hospitalization risk (pooled OR 0.78, 95% CI: 0.70–0.87; I² = 0.21) compared to usual care. RPM interventions with a self-management module (p < 0.001) and education module (p = 0.028) significantly lowered HF-related hospitalizations. Video calls during RPM interventions further reduced HF-related (p = 0.047) and all-cause hospitalizations (p < 0.001).

Conclusion

This meta-analysis confirms the efficacy of RPM in reducing HF-related hospitalizations and mortality. Effective components include self-management, education modules, and video communication. However, heterogeneity among interventions challenges the overall evaluation. Modernizing RPM with advanced technologies like non-invasive sensors, artificial intelligence, and cardiac telerehabilitation could enhance its potential.

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心衰患者远程监测：降低住院和死亡率的有效方案组成部分的综合荟萃分析

心衰（HF）的无创远程患者监测（RPM）方法仍然多种多样。了解影响RPM对hf相关和全因住院、死亡率和急诊科就诊有效性的因素对于制定成功的RPM干预措施至关重要。本荟萃分析旨在综合和比较影响HF相关和全因住院、死亡率和心衰患者急诊就诊的RPM成分的现有文献。

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来源期刊

European Journal of Heart Failure 医学-心血管系统

CiteScore

27.30

自引率

11.50%

发文量

365

审稿时长

1 months

期刊介绍： European Journal of Heart Failure is an international journal dedicated to advancing knowledge in the field of heart failure management. The journal publishes reviews and editorials aimed at improving understanding, prevention, investigation, and treatment of heart failure. It covers various disciplines such as molecular and cellular biology, pathology, physiology, electrophysiology, pharmacology, clinical sciences, social sciences, and population sciences. The journal welcomes submissions of manuscripts on basic, clinical, and population sciences, as well as original contributions on nursing, care of the elderly, primary care, health economics, and other related specialist fields. It is published monthly and has a readership that includes cardiologists, emergency room physicians, intensivists, internists, general physicians, cardiac nurses, diabetologists, epidemiologists, basic scientists focusing on cardiovascular research, and those working in rehabilitation. The journal is abstracted and indexed in various databases such as Academic Search, Embase, MEDLINE/PubMed, and Science Citation Index.