Telemonitoring didn’t help patients with heart failure

January 01, 0001

Telemonitoring didn’t help patients with heart failure

These US authors randomly assigned 1653 patients who had recently been hospitalized for heart failure to undergo either telemonitoring (826 patients) or usual care (827 patients). Telemonitoring was accomplished by means of a telephone-based interactive voice-response system that collected daily information about symptoms and weight that was reviewed by the patients' clinicians. The primary end point was readmission for any reason or death from any cause within 180 days after enrollment.

They found: "The median age of the patients was 61 years; 42.0% were female, and 39.0% were black. The telemonitoring group and the usual-care group did not differ significantly with respect to the primary end point, which occurred in 52.3% and 51.5% of patients, respectively (NS). Readmission for any reason occurred in 49.3% of patients in the telemonitoring group and 47.4% of patients in the usual-care group (NS). Death occurred in 11.1% of the telemonitoring group and 11.4% of the usual care group (NS). There were no significant differences between the two groups with respect to the secondary end points or the time to the primary end point or its components. No adverse events were reported."

The authors concluded: "Among patients recently hospitalized for heart failure, telemonitoring did not improve outcomes. The results indicate the importance of a thorough, independent evaluation of disease-management strategies before their adoption."

Not all efforts to improve quality actually improve outcomes.

For the full abstract, click here.

N Engl J Med published online 16 November 2010
© 2010 to the Massachusetts Medical Society
Telemonitoring in Patients with Heart Failure. Sarwat I. Chaudhry, Jennifer A. Mattera, Jeptha P. Curtis, et al. Correspondence to: Dr. Krumholz: [email protected]

Category: HSR. Health Services Research, K. Circulatory. Keywords: telemonitoring, heart failure, hospitalization, readmission, death, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 30 November 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.