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 ) .
Remote monitoring of implantable cardioverter defibrillators versus quarterly device interrogations in clinic: results from a randomized pilot clinical trial.
INTRODUCTION Remote monitoring is increasingly becoming the new st and ard of care for implantable cardioverter defibrillator ( ICD ) follow-up . We sought to determine whether remote monitoring of ICDs improves patient outcomes compared with quarterly device interrogations in clinic . METHODS AND RESULTS In this single-center pilot clinical trial , adult patients with an ICD were r and omly assigned to remote monitoring versus quarterly device interrogations in clinic . The primary endpoint was a composite of cardiovascular hospitalization , emergency room visit for a cardiac cause , and unscheduled visit to the electrophysiology clinic for a device-related issue at 1 year . We also examined health-related quality of life , costs , and patient satisfaction with their ICD care . Of 151 patients enrolled in this trial , 76 were r and omized to remote monitoring and 75 to quarterly device  interrogations in clinic . There was no significant difference in the primary endpoint ( 32 % in the remote monitoring arm vs 34 % in the control arm ; P = 0.8 ) , mortality , or cost between the 2 arms . Quality of life and patient satisfaction were significantly better in the control arm than in the remote monitoring arm at 6 months ( 83 [ 25th , 75th percentiles 70 , 90 ] vs 75 [ 50 , 85 ] ; P = 0.002 and 88 [ 75 , 100 ] vs 75 [ 75 , 88 ] ; P = 0.03 , respectively ) , but not at 12 months . CONCLUSION We showed no significant reduction in cardiac-related re source utilization with remote monitoring of ICDs . However , given the small number of patients in our study , the real clinical and health economics impact of remote monitoring needs to be verified by a large , multicenter , r and omized clinical trial
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 ) .