No favourable effect on mortality was observed with STS HM .
Similar reductions were observed in all-cause hospitalisations for TM interventions , whereas STS interventions had no major effect .
STS HM was dominated by usual care .
Similar results were observed in scenario analyses performed using higher costs of usual care , higher costs of STS HH and lower costs of TM during office hours .
As a result , the economic model developed scenarios for different RM classifications and their costs were estimated using bottom-up costing methods .
Despite wide variation in usual care and RM strategies , cost-effectiveness analyses suggest that TM during office hours was an optimal strategy ( in most costing scenarios ) .
However , clarity was lacking among descriptions of the components of RM packages and usual care and there was a lack of robust estimation of costs .
BACKGROUND Remote monitoring ( RM ) strategies have the potential to deliver specialised care and management to patients with heart failure ( HF ) .
OBJECTIVE To determine the clinical effectiveness and cost-effectiveness of home telemonitoring ( TM ) or structured telephone support ( STS ) strategies compared with usual care for adult patients who have been recently discharged ( within 28 days ) from acute care after a recent exacerbation of HF .
The review included r and omised controlled trials ( RCTs ) or observational cohort studies with a contemporaneous control group that included the following RM interventions : ( 1 ) TM ( including cardiovascular implanted monitoring devices ) with medical support provided during office hours or 24/7 ; ( 2 ) STS programmes delivered by human-to-human contact ( HH ) or human-to-machine interface ( HM ) .
Clinical benefits of remote versus transtelephonic monitoring of implanted pacemakers.
OBJECTIVES The purpose of this study was to evaluate remote pacemaker interrogation for the earlier diagnosis of clinical ly actionable events compared with traditional transtelephonic monitoring and routine in-person evaluation . BACKGROUND Pacemaker patient follow-up procedures have evolved from evaluating devices with little programmability and diagnostic information solely in person to transtelephonic rhythm strip recordings that allow monitoring of basic device function . More recently developed remote monitoring technology leverages exp and ed device capabilities , augmenting traditional transtelephonic monitoring to evaluate patients via full device interrogation . METHODS The time to first diagnosis of a clinical ly actionable event was compared in patients who were followed by remote interrogation ( Remote )  and those who were followed per st and ard of care with office visits augmented by transtelephonic monitoring ( Control ) . Patients were r and omized 2:1 . Remote arm  patients transmitted pacemaker information at 3-month intervals .  Control arm patients with a single-chamber pacemaker transmitted at 2-month intervals . Control arm patients with dual-chamber devices transmitted at 2-month intervals with an office visit at 6 months . All patients were seen in office at 12 months . RESULTS The mean time to first diagnosis of clinical ly actionable events was earlier in the Remote arm ( 5.7 months ) than in the Control arm ( 7.7 months ) . Three ( 2 % ) of the 190 events in the Control arm and 446 ( 66 % ) of 676 events in the Remote arm were identified remotely . CONCLUSIONS The strategic use of remote pacemaker interrogation follow-up detects actionable events that are potentially important more quickly and more frequently than transtelephonic rhythm strip recordings . The use of transtelephonic rhythm strips for pacemaker follow-up is of little value except for battery status determinations . ( PREFER [ Pacemaker Remote Follow-up Evaluation and Review ] ; NCT00294645 )
No favourable effect on mortality was observed with STS HM .
Similar reductions were observed in all-cause hospitalisations for TM interventions , whereas STS interventions had no major effect .
STS HM was dominated by usual care .
Similar results were observed in scenario analyses performed using higher costs of usual care , higher costs of STS HH and lower costs of TM during office hours .
As a result , the economic model developed scenarios for different RM classifications and their costs were estimated using bottom-up costing methods .
Despite wide variation in usual care and RM strategies , cost-effectiveness analyses suggest that TM during office hours was an optimal strategy ( in most costing scenarios ) .
However , clarity was lacking among descriptions of the components of RM packages and usual care and there was a lack of robust estimation of costs .
BACKGROUND Remote monitoring ( RM ) strategies have the potential to deliver specialised care and management to patients with heart failure ( HF ) .
OBJECTIVE To determine the clinical effectiveness and cost-effectiveness of home telemonitoring ( TM ) or structured telephone support ( STS ) strategies compared with usual care for adult patients who have been recently discharged ( within 28 days ) from acute care after a recent exacerbation of HF .
The review included r and omised controlled trials ( RCTs ) or observational cohort studies with a contemporaneous control group that included the following RM interventions : ( 1 ) TM ( including cardiovascular implanted monitoring devices ) with medical support provided during office hours or 24/7 ; ( 2 ) STS programmes delivered by human-to-human contact ( HH ) or human-to-machine interface ( HM ) .