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 ) .
[Impact of telemetric management on overall treatment costs and mortality rate among patients with chronic heart failure].
BACKGROUND AND OBJECTIVE The rising prevalence of chronic heart failure ( CHF ) has led to an increase in total treatment expenditures . A medical care programme of telemetry was developed to reduce the number of patients with decompensated CHF , hospital admissions and overall treatment cost . PATIENTS AND METHODS As part of a prospect i ve controlled study the body weight of 251 patients with CHF was monitored over one year . The supervising center contacted the patients whenever their body weight exceeded a threshold value . Patients were phoned by a design ated personal adviser and received regular informative material and advice by specialist medical personnel . Patients ' general practitioners had been involved in recruiting patients and by regularly sending them follow-up reports . Another group of 251 patients who had not received the described telemetric intervention served as control . RESULTS The mean age of the patients was 71.7 years , lower than the 76.4 years of the control group . More patients in the intervention groups were in NYHA class III and IV than in the control group ( 52 % vs 36 % ) . After an average observation period of 12 months the duration of hospital stay had been reduced by 48 % ( p = 0.01 ) , the hospital costs by EUR 7128 per patient p = 0.01 ) , while drug expenditure had increased by EUR 245 per patient ( not significant ) . The total costs had thus fallen by EUR 6993 per patient ( -39.5 % ; p = 0.05 ) . The mortality rate of 14.7 % in the intervention group was significantly lower than that of the control group of 27.1 % ( p = 0.001 ) . The reduction in costs and mortality rate was clearly greater for men than women . Total expenditure had been highest for patients who had died . CONCLUSION The results indicate that total treatment costs and mortality rate can be reduced by telemetric monitoring of  patients in CHF , especially in men
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 ) .