[Letter to the Editor] Telemonitoring in Patients with Heart Failure
Inglis, S. C., Clark, R. A., & Cleland, J. G. F. (2011) [Letter to the Editor] Telemonitoring in Patients with Heart Failure. New England Journal of Medicine, 364(11), pp. 1078-1079.
To the Editor:
Chaudhry et al. suggest that enhanced support in the use of a telephone-based interactive voice-response system for patients recently discharged after worsening heart failure does not improve outcomes. This finding is broadly consistent with previous systematic reviews of telephone support1 and contrasts with the substantial effect observed with home telemonitoring of vital signs in similar populations.1 The treatment of patients in the control group was excellent, but unrepresentative of usual clinical care and not inferior to the treatment of patients receiving enhanced support. Monitoring alone is unlikely to improve outcomes but may do so when it improves prescription of or adherence to lifesaving treatments. Given enough resources, traditional methods for delivering care may render an interactive voice-response system or a home telemonitoring system ineffective. Nonetheless, there may be more cost-efficient approaches to ensuring quality care.2
Informal post hoc addition of these data to our recent meta-analysis of telephone support1 does not substantially alter the point estimates for death from any cause or heart-failure−related hospitalizations, but it does nullify the small benefit in hospitalizations for any cause, which may not be reduced by a heart-failure−focused intervention.1
Original article: Telemonitoring in Patients with Heart Failure NEJM. December 9, 2010 | S.I. Chaudhry and Others
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|Item Type:||Journal Article|
|Keywords:||deterioration, health care delivery, heart failure, home monitoring, hospital discharge, hospitalization, human, interactive voice response system, letter, outcome assessment, priority journal, telemonitoring, telephone, vital sign, meta analysis (topic), methodology, monitoring, note, telemedicine, human relation, mobile phone, patient care, Humans, Meta-Analysis as Topic, Monitoring, Physiologic, Cellular Phone, Patient-Centered Care, Professional-Patient Relations|
|Subjects:||Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000)|
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CARDIOVASCULAR MEDICINE AND HAEMATOLOGY (110200)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700)
|Divisions:||Current > QUT Faculties and Divisions > Faculty of Health|
Current > Schools > School of Nursing
|Copyright Owner:||New England Journal of Medicine|
|Deposited On:||30 Nov 2011 12:18|
|Last Modified:||26 Dec 2012 00:15|
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