Effects of Home Telemonitoring Interventions on Patients With Chronic Heart Failure: An Overview of Systematic Reviews

Kitsiou, Spyros; Paré, Guy; Jaana, Mirou

doi:10.2196/jmir.4174

Cited by 248 publications

(247 citation statements)

References 73 publications

(181 reference statements)

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“…Prior research in the area of TM has focused on the impacts of this patient management approach, mostly in relation to symptoms, mortality, and the utilization of services [17,18,23]. Yet, limited evidence exists on the actual effects of TM on patients' behaviors, especially patient empowerment and selfcare, with the exception of general discussion on patients' acceptability and attitude towards the technology.…”

Section: Literature Reviewmentioning

confidence: 99%

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confidence: 99%

“…It employs telecommunication tools to transmit physiological or clinical data from a home setting to a health care center responsible for providing ongoing follow-up and treatment [17]. Hence, it supports effective management of patients [14] and allows early detection of deterioration in patients' conditions and timely intervention, which can prevent death and hospitalization [17]. Despite its benefits to a broad range of patients (e.g., [13,14,15]), TM may be particularly useful for elderly patients, especially for patients living in remote areas or housebound [19].…”

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confidence: 99%

“…In a recent overview of systematic reviews on TM and HF, Kitsiou et al [17] recommended that future research assess the process by which TM works, investigate whether effectiveness varies between different patient groups, and identify optimal strategies for its success. This is especially important given the reported variation in compliance when using TM [29], and the particularities of elderly patients' that may influence their use of this technology.…”

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confidence: 99%

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Telemonitoring for Seniors with Chronic Heart Failure: Patient Self-Care, Empowerment, and Adoption Factors

Jaana

Tamim

Sherrard

et al. 2017

Proceedings of the 50th Hawaii International Conference on System Sciences (2017)

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Section: Literature Reviewmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Telemonitoring for Seniors with Chronic Heart Failure: Patient Self-Care, Empowerment, and Adoption Factors

Jaana

Tamim

Sherrard

et al. 2017

Proceedings of the 50th Hawaii International Conference on System Sciences (2017)

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“…In recent years, many projects and programs have been initiated with the objective to develop new models of service delivery, capitalizing on the potential of telehealth to improve accessibility, quality, continuity, efficiency and integration of health care and services, especially for populations with chronic diseases and those living in rural and remote areas [2,[4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Involving Citizen-Patients in the Development of Telehealth Services: Qualitative Study of Experts’ and Citizen-Patients’ Perspectives (Preprint)

Alami¹,

Gagnon²,

Fortin³

2018

Preprint

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BACKGROUND Decisions regarding telehealth services in Quebec (Canada) have been largely technocratic by nature for the last 15 years, and the involvement of citizen-patients in the development of telehealth services is virtually nonexistent. In view of the societal challenges that telehealth raises, citizen-patient involvement could ensure more balance between evidence from traditional research methodologies and technical experts and the needs and expectations of populations in decisions about telehealth services. OBJECTIVE This study aimed to explore the perception of various stakeholders (decision makers, telehealth program and policy managers, clinicians, researchers, evaluators, and citizen-patients) regarding the involvement of citizen-patients in the development of telehealth services in Quebec. In particular, we explored its potential advantages, added value, obstacles, and challenges it raises for decision making. METHODS We used a qualitative research approach based on semistructured individual interviews, with a total of 29 key actors. Respondents were identified by the contact network method. Interviews were recorded and transcribed verbatim. A pragmatic content thematic analysis was performed. To increase the capacity for interpretation and analysis, we were guided by the principle of data triangulation. RESULTS Citizen-patient involvement in decision making is perceived more as a theoretical idea than as a practical reality in health care organizations or in the health system. There is very little connection between citizen involvement structures or patient and user groups and telehealth leaders. For the respondents, citizen-patient involvement in telehealth could increase the accountability and transparency of decision making and make it more pragmatic within an innovation-driven health system. This involvement could also make citizen-patients ambassadors and promoters of telehealth and improve the quality and organization of health services while ensuring they are more socially relevant. Challenges and constraints that were reported include the ambiguity of the citizen-patient, who should be involved and how, claimant citizen-patient, the risk of professionalization of citizen-patient involvement, and the gap between decision time versus time to involve the citizen-patient. CONCLUSIONS This study provides a basis for future research on the potential of involving citizen-patients in telehealth. There is a great need for research on the issue of citizen-patient involvement as an organizational innovation (in terms of decision-making model). Research on the organizational predisposition and preparation for such a change becomes central. More efforts to synthesize and translate knowledge on public participation in decision making in the health sector, particularly in the field of technology development, are needed.

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Multifaceted Strategy Based on Automated Text Messaging After a Recent Heart Failure Admission

Rohde,

Rover,

Hoffmann Filho

et al. 2024

JAMA Cardiol

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ImportanceReadmissions after an index heart failure (HF) hospitalization are a major contemporary health care problem.ObjectiveTo evaluate the feasibility and efficacy of an intensive telemonitoring strategy in the vulnerable period after an HF hospitalization.Design, Setting, and ParticipantsThis randomized clinical trial was conducted in 30 HF clinics in Brazil. Patients with left ventricular ejection fraction less than 40% and access to mobile phones were enrolled up to 30 days after an HF admission. Data were collected from July 2019 to July 2022.InterventionParticipants were randomly assigned to a telemonitoring strategy or standard care. The telemonitoring group received 4 daily short message service text messages to optimize self-care, active engagement, and early intervention. Red flags based on feedback messages triggered automatic diuretic adjustment and/or a telephone call from the health care team.Main Outcomes and MeasuresThe primary end point was change in N-terminal pro–brain natriuretic peptide (NT-proBNP) from baseline to 180 days. A hierarchical win-ratio analysis incorporating blindly adjudicated clinical events (cardiovascular deaths and HF hospitalization) and variation in NT-proBNP was also performed.ResultsOf 699 included patients, 460 (65.8%) were male, and the mean (SD) age was 61.2 (14.5) years. A total of 352 patients were randomly assigned to the telemonitoring strategy and 347 to standard care. Satisfaction with the telemonitoring strategy was excellent (net promoting score at 180 days, 78.5). HF self-care increased significantly in the telemonitoring group compared with the standard care group (score difference at 30 days, −2.21; 95% CI, −3.67 to −0.74; P = .001; score difference at 180 days, −2.08; 95% CI, −3.59 to −0.57; P = .004). Variation of NT-proBNP was similar in the telemonitoring group compared with the standard care group (telemonitoring: baseline, 2593 pg/mL; 95% CI, 2314-2923; 180 days, 1313 pg/mL; 95% CI, 1117-1543; standard care: baseline, 2396 pg/mL; 95% CI, 2122-2721; 180 days, 1319 pg/mL; 95% CI, 1114-1564; ratio of change, 0.92; 95% CI, 0.77-1.11; P = .39). Hierarchical analysis of the composite outcome demonstrated a similar number of wins in both groups (telemonitoring, 49 883 of 122 144 comparisons [40.8%]; standard care, 48 034 of 122 144 comparisons [39.3%]; win ratio, 1.04; 95% CI, 0.86-1.26).Conclusions and RelevanceAn intensive telemonitoring strategy applied in the vulnerable period after an HF admission was feasible, well-accepted, and increased scores of HF self-care but did not translate to reductions in NT-proBNP levels nor improvement in a composite hierarchical clinical outcome.Trial RegistrationClinicalTrials.gov Identifier: NCT04062461

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Effects of Home Telemonitoring Interventions on Patients With Chronic Heart Failure: An Overview of Systematic Reviews

Cited by 248 publications

References 73 publications

Telemonitoring for Seniors with Chronic Heart Failure: Patient Self-Care, Empowerment, and Adoption Factors

Telemonitoring for Seniors with Chronic Heart Failure: Patient Self-Care, Empowerment, and Adoption Factors

Involving Citizen-Patients in the Development of Telehealth Services: Qualitative Study of Experts’ and Citizen-Patients’ Perspectives (Preprint)

Multifaceted Strategy Based on Automated Text Messaging After a Recent Heart Failure Admission

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