Table 2 Telemonitoring studies with a positive outcome
Paper | Setting | Disease | Parameters measured (frequency) | Transmission frequency | Review frequency | Outcome |
|---|---|---|---|---|---|---|
In hospital - ICU | Multiple - all critically ill patients | Multiple continuously; all measured parameters + video monitoring | Continuously | Continuously | Reduced mortality by up to 33%, number of ventilator days by up to 25%, length of stay by up to 17% | |
Antonicelli et al. 2008 [30] | Community | Chronic heart failure (CHF) | BP (daily), ECG (weekly), body weight (weekly), 24-h urine output (weekly) | Daily | Weekly | Telecare versus usual care: decreased hospital readmission 9 versus 26 (P < 0.01); trend towards decreased mortality 3 versus 5; total patients 28 versus 29 (N = 57) |
Fursse et al. 2008 [29] | Community | Diabetes, hypertension, CHF | Blood glucose (daily), BP (daily), SpO2 (daily) | Daily | On alerts, regularly - not specified | Mean reductions of 11 mmHg systolic and 2 mmHg diastolic in patients with CHF, 0.4% HbA1c in those with diabetes, and 12 mmHg systolic and 2 mmHg diastolic in those with hypertension (no control group; N = 29) |
Green et al. 2008 [31] | Community | Hypertension | BP (twice weekly) | Twice weekly | Fortnightly | Higher proportion of patients (after 12 months) whose BP was controlled (< 140/90); telemonitored group 56% versus usual care 31% (80% increase; N = 778) |
Kisner et al. 2008 [61] | In hospital - ward | Atrial fibrillation post CABG | SpO2 (continuously) | Continuously | On alerts | Incidence of atrial fibrillation in telemonitored group was 14% versus 26% (prior to telemonitoring; P = 0.016; N = 119; control cohort = 238) |
Morguet et al. 2008 [33] | Community | CHF | Weight (daily), BP (daily), pulse rate (daily), ECG (on request) | Daily | Twice weekly, on alerts | 50% reduction in hospital admissions (38 versus 77/100 patient years, P = 0.034), 54% reduction in hospital length of stay (317 versus 693 days/100 patient years; P < 0.0001) (N = 128) |
Nakamoto et al. 2008 [63] | Community | Hypertension: drug trial of temlisartan versus amlodipine | BP (twice daily) | Twice daily | End of study | Evening systolic BP reductions higher in telmisartan versus amlodipine group (13 ± 3 versus 6 ± 3 mmHg); non-significant differences in morning BP reduction between both groups; better daytime normalization with telmisartan (N = 40) |
Nielsen et al. 2008 [27] | Community | ICD, pacemaker | ECG (continuously) | Daily, on alerts | On alerts | 26% of unplanned clinic visits initiated by telemonitored data (N = 260) |
Ricci et al. 2008 [28] | Community | ICD, pacemaker | ECG (continuously) | Daily, on alerts | Fortnightly, on alerts | 37% of patients had changes to their medication, device reprogramming, or were called in for further investigations (N = 117) |
Woodend et al. 2008 [34] | Community | Angina, heart Failure | BP (daily), weight (daily), ECG (not specified) | Daily | Weekly | 32% reduction in hospital admission (0.4 versus 0.59 hospital readmission rate per patient, P = 0.048); 46% reduction in length of stay in hospital if readmitted (2.11 versus 3.93 days, P = 0.038) (N = 249) |
Parati et al. 2009 [35] | Community | Hypertension | BP (not specified) | Not specified | On alerts | Increased daytime BP normalization (< 130/90), 62% versus 50% (P < 0.05); less frequent treatment changes, 9% versus 14% (P < 0.05) (N = 228) |