Diedrich L, Dockweiler C, Kupitz A, Hornberg C
Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Universitätsstraße 25, 33615, Bielefeld, Deutschland.
Herz. 2018 Jun;43(4):298-309. doi: 10.1007/s00059-017-4579-9. Epub 2017 Jun 7.
Heart failure is one of the most common and cost-intensive chronic diseases worldwide. Telemonitoring offers the potential to improve care of heart failure treatment and reduce cost. Empirical findings of its efficacy are inconsistent up to now. This systematic review examines the current state of research regarding health-related and economic endpoints.
A systematic review was conducted in July 2016 using the PubMed database and randomised controlled trials for the years 2011-2016. Only clinical research trials with heart failure patients were considered where the intervention was performed using external monitoring devices which transmitted data via information and communication technology. In all, 10 clinical trials were included.
There is no definite evidence regarding improvement in care based solely on the most recent literature. Hospitalisation for heart failure and health-related quality of life were most positively influenced. There was no correlation between mortality and hospitalisations for all causes regarding telemonitoring. The overall costs tended to be higher for telemonitoring.
Further research is needed to examine the health-related and economic benefits of telemonitoring for heart failure. A particular challenge is the evidence of cause-effect relationships within complex technology-supported health-care settings. The latest studies support the previous state of research.
心力衰竭是全球最常见且成本高昂的慢性疾病之一。远程监测有改善心力衰竭治疗护理并降低成本的潜力。截至目前,关于其疗效的实证研究结果并不一致。本系统综述考察了有关健康相关及经济终点的研究现状。
2016年7月利用PubMed数据库及2011 - 2016年的随机对照试验进行了一项系统综述。仅纳入针对心力衰竭患者的临床研究试验,这些试验使用通过信息通信技术传输数据的外部监测设备进行干预。总共纳入了10项临床试验。
仅依据最新文献,尚无明确证据表明护理得到改善。心力衰竭住院率及健康相关生活质量受到的积极影响最大。远程监测与全因死亡率及住院率之间无相关性。远程监测的总体成本往往更高。
需要进一步研究以考察心力衰竭远程监测的健康相关及经济效益。一个特殊挑战是在复杂的技术支持医疗环境中证明因果关系。最新研究支持了先前的研究状况。