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 ) .
Relation between modifiable lifestyle factors and lifetime risk of heart failure.
CONTEXT The lifetime risk of  heart failure at age 40 years is approximately 1 in 5 in the general population ; however , little is known about the association between modifiable lifestyle factors and the remaining lifetime risk of heart failure . OBJECTIVE To examine the association between modifiable lifestyle factors and the lifetime risk of heart failure in a large cohort of men . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve cohort study using data from 20,900 men ( mean age at baseline , 53.6 years ) from the Physicians ' Health Study I ( 1982 - 2008 ) who were apparently healthy at baseline . Six modifiable lifestyle factors were assessed : body weight , smoking , exercise , alcohol intake , consumption of breakfast cereals , and consumption of fruits and vegetables . MAIN OUTCOME MEASURE Lifetime risk of heart failure . RESULTS During a mean follow-up of 22.4 years , 1200 men developed heart failure . Overall , the lifetime risk of heart failure was 13.8 % ( 95 % confidence interval [ CI ] , 12.9%-14.7 % ) at age 40 years . Lifetime risk remained constant in men who survived free of heart failure through age 70 years and reached 10.6 % ( 95 % CI , 9.4%-11.7 % ) at age 80 years . Lifetime risk of heart failure was higher in men with hypertension than in those without hypertension . Healthy lifestyle habits ( normal body weight , not smoking , regular exercise , moderate alcohol intake , consumption of breakfast cereals , and consumption of fruits and vegetables ) were individually and jointly associated with a lower lifetime risk of heart failure , with the highest risk in men adhering to none of the 6 lifestyle factors ( 21.2 % ; 95 % CI , 16.8%-25.6 % ) and the lowest risk in men adhering to 4 or more desirable factors ( 10.1 % ; 95 % CI , 7.9%-12.3 % ) . CONCLUSION In this cohort of apparently healthy men , adherence to healthy lifestyle factors is associated with a lower lifetime risk of heart failure
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 ) .