Kwaah Patrick A, Olumuyide Emmanuel, Farhat Kassem, Malaga-Espinoza Barbara, Abdullah Ahmed, Beasley Michael H, Sari Novi Y, Stern Lily K, Lamprea-Montealegre Julio A, daSilva-deAbreu Adrian, Hu Jiun-Ruey
Department of Internal Medicine, Yale School of Medicine, Waterbury, CT 06708, USA.
Department of Internal Medicine, Advocate Illinois Masonic Medical Centre, Chicago, IL 60657, USA.
Medicina (Kaunas). 2025 Jul 15;61(7):1277. doi: 10.3390/medicina61071277.
Heart failure (HF) represents a major public health challenge worldwide, with rising prevalence, high morbidity and mortality rates, and substantial healthcare costs. Non-invasive telemonitoring has emerged as a promising adjunct in HF management, yet its clinical effectiveness remains unclear. In this systematic review, we summarize randomized controlled trials (RCTs) between 2004 and 2024 examining the efficacy of non-invasive telemonitoring on mortality, readmission, and quality of life (QoL) in HF. In addition, we characterize the heterogeneity of features of different telemonitoring interventions. In total, 32 RCTs were included, comprising 13,294 participants. While some individual studies reported benefits, non-invasive telemonitoring demonstrated mixed effects on mortality, readmission rates, and QoL. The most common modality for interfacing with patients was by mobile application (53%), followed by web portals (22%), and stand-alone devices (19%). Periodic feedback (63%) was more common than continuous feedback (31%) or on-demand feedback (6%). Clinician reviews of patient telemonitoring data was event-triggered (44%) more commonly than based on a prespecified timeline (38%). In most designs (90%), patients played a passive role in telemonitoring. Non-invasive telemonitoring interventions for HF exhibited considerable variation in duration and system design and had a low rate of patient engagement. Future work should focus on identifying telemonitoring-responsive subgroups and refining telemonitoring strategies to complement traditional HF care.
心力衰竭（HF）是全球主要的公共卫生挑战，其患病率不断上升，发病率和死亡率高，医疗成本巨大。无创远程监测已成为心力衰竭管理中一种有前景的辅助手段，但其临床效果仍不明确。在这项系统评价中，我们总结了2004年至2024年间的随机对照试验（RCT），这些试验考察了无创远程监测对心力衰竭患者死亡率、再入院率和生活质量（QoL）的疗效。此外，我们还描述了不同远程监测干预措施特征的异质性。总共纳入了32项随机对照试验，涉及13294名参与者。虽然一些个别研究报告了益处，但无创远程监测对死亡率、再入院率和生活质量的影响不一。与患者交互的最常见方式是通过移动应用程序（53%），其次是门户网站（22%）和独立设备（19%）。定期反馈（63%）比持续反馈（31%）或按需反馈（6%）更常见。临床医生对患者远程监测数据的审查更多是事件触发（44%），而非基于预先设定的时间线（38%）。在大多数设计中（90%），患者在远程监测中扮演被动角色。用于心力衰竭的无创远程监测干预措施在持续时间和系统设计方面存在很大差异，患者参与率较低。未来的工作应侧重于识别对远程监测有反应的亚组，并完善远程监测策略，以补充传统的心力衰竭护理。
