The quality of evidence is downgraded by suspected publication bias (asymmetrical funnel plot).
A Cochrane review [Abstract] 1 included 41 studies of either structured telephone support or non-invasive home telemonitoring for people with heart failure. 25 studies evaluated structured telephone support (n=9 332), 18 evaluated telemonitoring (n=3 860), and 2 tested both interventions (included in counts). Programmes were classified as structured telephone support if the monitoring and/or self-care management was delivered using simple telephone technology and telemonitoring if there was digital/broadband/satellite/wireless or blue-tooth transmission of physiologic and other non-invasive data.
Non-invasive telemonitoring reduced all-cause mortality (RR 0.80, 95% CI 0.68 to 0.94; 17 studies, n=3 740) and heart failure-related hospitalisations (RR 0.71, 95% CI 0.60 to 0.83; 8 studies, n=2 148). Structured telephone support reduced all-cause mortality (RR 0.87, 95% CI 0.77 to 0.98; 22 studies, n=9 222) and heart failure-related hospitalisations (RR 0.85, 95% CI 0.77 to 0.93; 16 studies, n=7 030).Neither structured telephone support nor telemonitoring reduced all-cause hospitalisations.Nine of 11 structured telephone support studies and 5 of 11 telemonitoring studies reported significant improvements in health-related quality of life. Participant acceptance of the intervention was reported in the range of 76% to 97% for studies which evaluated this outcome. Seven of nine studies that measured these outcomes reported significant improvements in heart failure knowledge and self-care behaviours.
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