Impact of Remote Telehealth on Patients with Heart Failure: A Meta-Analysis

Abstract

Abstract Aims: The use of telehealth for heart failure management is increasing and it is not clear from the literature whether it is more beneficial than usual care. A meta-analysis was done of published randomized controlled trials to compare telehealth management and usual physician care for heart failure patients. The primary outcomes studied include mortality, hospital readmissions and quality of life. Methods: A systematic search was done to identify trials that met the inclusion criteria. To be included a study had to be a randomized controlled trial published in English with all participants diagnosed with heart failure. Studies had to compare usual care to telehealth with at least one of the outcomes in this analysis. Data was extracted and classified using the AHA taxonomy for disease management and RevMan 5.3 was used for the data analysis. All outcomes were calcu- lated using random effects models and the quality of life outcome used the mean difference. Results: 1548 studies were screened against the above inclusion and exclusion criteria. This resulted in 8 randomized controlled trials being selected for meta-analysis with individual com- parisons for each outcome studied. Telehealth interventions showed no significant benefits over usual care for all main outcomes. All-cause mortality (p=0.38, 95% CI 0.69-1.16), heart failure related hospitalizations (p=0.67, 95% CI 0.76-1.20), all-cause rehospitalization (p=0.76, 95% CI 0.96-1.10) and quality of life (p=0.78, 95% CI -6.59 to -4.94). Conclusions: Current telehealth based interventions for HF self-care show no benefit over usual care. Keywords: Heart failure, telehealth, usual care, morbidity, mortality, quality of life, readmission.