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 Telemedical Care and Monitoring on Morbidity in Mild to Moderate Chronic Heart Failure
Objective : We investigated in a pilot study whether telemedicine is beneficial in mild to moderate chronic heart failure . Methods : A total of 128 patients with an ejection fraction ≤60 % and NYHA class II or III chronic heart failure were evaluated . Thirty-two patients were enrolled prospect ively in a staged telemedical service program .  Ninety-six controls were matched 3:1 to each telemedicine patient . Results : Median follow-up was 307 days ( range 104–459 ) . All-cause hospitalization duration [ 317 vs. 693 days/100 patient years ; relative risk ( RR ) 0.46 ; 95 % confidence interval ( CI ) 0.37–0.58 ; p < 0.0001 ) and rate ( 38 vs. 77/100 patient years ; RR 0.49 ; 95 % CI 0.25–0.95 ; p = 0.034 ) as well as cardiac hospitalization duration ( 49 vs. 379 days/100 patient years ; RR 0.13 ; 95 % CI 0.08–0.23 ; p < 0.0001 ] were significantly lower , cardiac hospitalization rate ( 11 vs. 35/100 patient years ; RR 0.31 ; 95 % CI 0.11–1.02 ; p = 0.058 ) tended to be lower in the telemedicine compared with the control group . Conclusion : These preliminary data suggest that telemedical care and monitoring may reduce morbidity in patients with NYHA class II and III chronic heart failure
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 ) .