Conclusion : Despite a systematic bias towards recruitment of individuals younger than the epidemiological average into the r and omized controlled trials , older people with heart failure did benefit from structured telephone support and telemonitoring .
While further research is required to confirm these observational findings , the evidence at h and indicates that discrimination by age alone may be not be appropriate when inviting participation in a remote monitoring service for heart failure
Background : There are few data regarding the effectiveness of remote monitoring for older people with heart failure .
We conducted a post-hoc sub- analysis of a previously published large Cochrane systematic review and meta- analysis of relevant r and omized controlled trials to determine whether structured telephone support and telemonitoring were effective in this population .
Case management in a heterogeneous congestive heart failure population: a randomized controlled trial.
BACKGROUND Both r and omized and nonr and omized controlled studies have linked congestive heart failure ( CHF ) case management ( CM ) to decreased readmissions and improved outcomes in mostly homogeneous setting s. The objective of this r and omized controlled trial was to test the effect of CHF CM on the 90-day readmission rate in a more heterogeneous setting . METHODS A total of 287 patients admitted to the hospital with the primary or secondary diagnosis of CHF , left ventricular dysfunction of less than 40 % , or radiologic evidence of pulmonary edema for which they underwent diuresis were r and omized . The intervention consisted of 4 major components : early discharge planning , patient and family CHF education , 12 weeks of telephone follow-up , and promotion of optimal CHF medications . RESULTS The 90-day readmission rates were equal for the CM and usual care groups ( 37 % ) . Total inpatient and outpatient median costs and readmission median cost were reduced 14 % and 26 % , respectively , for the intervention group . Patients in the CM group were more likely to be taking CHF medication at target doses , but dosages did not increase significantly throughout 12 weeks . Although both groups took their medications as prescribed equally well , the rest of the adherence to treatment plan was significantly better in the CM group . Subgroup analysis of patients who lived locally and saw a cardiologist showed a significant decrease in CHF readmissions for the intervention group ( P = .03 ) . CONCLUSIONS These results suggest several limitations to the generalizability of the CHF CM-improved outcome link in a heterogeneous setting . One explanation is that the lack of coordinated system supports and varied accessibility to care in an extended , nonnetworked physician setting limits the effectiveness of the CM
Conclusion : Despite a systematic bias towards recruitment of individuals younger than the epidemiological average into the r and omized controlled trials , older people with heart failure did benefit from structured telephone support and telemonitoring .
While further research is required to confirm these observational findings , the evidence at h and indicates that discrimination by age alone may be not be appropriate when inviting participation in a remote monitoring service for heart failure
Background : There are few data regarding the effectiveness of remote monitoring for older people with heart failure .
We conducted a post-hoc sub- analysis of a previously published large Cochrane systematic review and meta- analysis of relevant r and omized controlled trials to determine whether structured telephone support and telemonitoring were effective in this population .