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 ) .
Health-related quality of life in a multicenter randomized controlled comparison of telephonic disease management and automated home monitoring in patients recently hospitalized with heart failure: SPAN-CHF II trial.
BACKGROUND Although disease management programs have been shown to provide a number of clinical benefits to patients with heart failure ( HF ) , the incremental impact of an automated home monitoring ( AHM ) system on health-related quality of life ( HRQL ) is unknown . METHODS AND RESULTS We performed a prospect i ve r and omized investigation , examining the additive value of AHM to a previously described nurse-directed HF disease management program ( SPAN-CHF ) , with attention to HRQL , in patients with a recent history of decompensated HF . A total of 188 patients were r and omized to receive the SPAN-CHF intervention for 90 days , either with ( AHM group ) or without ( NAHM , st and ard-care group ) AHM , with a 1:1 r and omization ratio after HF-related hospitalization . HRQL , measured by the Minnesota Living With Heart Failure Question naire ( MLHFQ ) ( Physical , Emotional , and Total scores on MLHFQ ) was assessed at 3 time points : baseline , 45 days , and 90 days . Although both treatments ( AHM and NAHM ) improved HRQL at 45 and 90 days compared with baseline with respect to Physical , Emotional , and Total domain scales , no significant difference emerged between AHM and NAHM groups . CONCLUSIONS AHM and NAHM treatments demonstrated improved HRQL scores at 45 and 90 days after baseline assessment . When comparing 2 state-of the-art disease management programs regarding HRQL outcomes , our results did not support the added value of AHM
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 ) .