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 ) .
Adherence, adaptation and acceptance of elderly chronic heart failure patients to receiving healthcare via telephone-monitoring.
BACKGROUND Although the potential to reduce hospitalisation and mortality in chronic heart failure ( CHF ) is well reported , the feasibility of receiving healthcare by structured telephone support or telemonitoring is not . AIMS To determine ; adherence , adaptation and acceptability to a national nurse-coordinated telephone-monitoring CHF management strategy . The Chronic Heart Failure Assistance by Telephone Study ( CHAT ) . METHODS Triangulation of descriptive statistics , feedback surveys and qualitative analysis of clinical notes . Cohort comprised of st and ard care plus intervention ( SC+I ) participants who completed the first year of the study . RESULTS 30 GPs ( 70 % rural ) r and omised to SC+I recruited 79 eligible participants , of whom 60 ( 76 % ) completed the full 12 month follow-up period . During this time 3619 calls were made into the CHAT system ( mean 45.81 SD+/-79.26 , range 0 - 369 ) , Overall there was an adherence to the study protocol of 65.8 % ( 95 % CI 0.54 - 0.75 ; p=0.001 ) however , of the 60 participants who completed the 12 month follow-up period the adherence was significantly higher at 92.3 % ( 95 % CI 0.82 - 0.97 , p < or=0.001 ) . Only 3 % of this elderly group ( mean age 74.7+/-9.3 years ) were unable to learn or competently use the technology . Participants rated CHAT with a total acceptability rate of 76.45 % . CONCLUSION This study shows that elderly CHF patients can adapt quickly , find telephone-monitoring an acceptable part of their healthcare routine , and are able to maintain good adherence for a least 12 months
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 ) .