PMID- 20687083
OWN - NLM
STAT- MEDLINE
DCOM- 20100825
LR  - 20220409
IS  - 1469-493X (Electronic)
IS  - 1361-6137 (Linking)
IP  - 8
DP  - 2010 Aug 4
TI  - Structured telephone support or telemonitoring programmes for patients with 
      chronic heart failure.
PG  - CD007228
LID - 10.1002/14651858.CD007228.pub2 [doi]
AB  - BACKGROUND: Specialised disease management programmes for chronic heart failure 
      (CHF) improve survival, quality of life and reduce healthcare utilisation. The 
      overall efficacy of structured telephone support or telemonitoring as an 
      individual component of a CHF disease management strategy remains inconclusive. 
      OBJECTIVES: To review randomised controlled trials (RCTs) of structured telephone 
      support or telemonitoring compared to standard practice for patients with CHF in 
      order to quantify the effects of these interventions over and above usual care 
      for these patients. SEARCH STRATEGY: Databases (the Cochrane Central Register of 
      Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects (DARE) 
      and Health Technology Assessment Database (HTA) on The Cochrane Library, MEDLINE, 
      EMBASE, CINAHL, AMED and Science Citation Index Expanded and Conference Citation 
      Index on ISI Web of Knowledge) and various search engines were searched from 2006 
      to November 2008 to update a previously published non-Cochrane review. 
      Bibliographies of relevant studies and systematic reviews and abstract conference 
      proceedings were handsearched. No language limits were applied. SELECTION 
      CRITERIA: Only peer reviewed, published RCTs comparing structured telephone 
      support or telemonitoring to usual care of CHF patients were included. 
      Unpublished abstract data was included in sensitivity analyses. The intervention 
      or usual care could not include a home visit or more than the usual (four to six 
      weeks) clinic follow-up. DATA COLLECTION AND ANALYSIS: Data were presented as 
      risk ratio (RR) with 95% confidence intervals (CI). Primary outcomes included 
      all-cause mortality, all-cause and CHF-related hospitalisations which were 
      meta-analysed using fixed effects models. Other outcomes included length of stay, 
      quality of life, acceptability and cost and these were described and tabulated. 
      MAIN RESULTS: Twenty-five studies and five published abstracts were included. Of 
      the 25 full peer-reviewed studies meta-analysed, 16 evaluated structured 
      telephone support (5613 participants), 11 evaluated telemonitoring (2710 
      participants), and two tested both interventions (included in counts). 
      Telemonitoring reduced all-cause mortality (RR 0.66, 95% CI 0.54 to 0.81, P < 
      0.0001) with structured telephone support demonstrating a non-significant 
      positive effect (RR 0.88, 95% CI 0.76 to 1.01, P = 0.08). Both structured 
      telephone support (RR 0.77, 95% CI 0.68 to 0.87, P < 0.0001) and telemonitoring 
      (RR 0.79, 95% CI 0.67 to 0.94, P = 0.008) reduced CHF-related hospitalisations. 
      For both interventions, several studies improved quality of life, reduced 
      healthcare costs and were acceptable to patients. Improvements in prescribing, 
      patient knowledge and self-care, and New York Heart Association (NYHA) functional 
      class were observed. AUTHORS' CONCLUSIONS: Structured telephone support and 
      telemonitoring are effective in reducing the risk of all-cause mortality and 
      CHF-related hospitalisations in patients with CHF; they improve quality of life, 
      reduce costs, and evidence-based prescribing.
FAU - Inglis, Sally C
AU  - Inglis SC
AD  - Preventative Health, Baker IDI Heart and Diabetes Institute, Melbourne, 
      Australia.
FAU - Clark, Robyn A
AU  - Clark RA
FAU - McAlister, Finlay A
AU  - McAlister FA
FAU - Ball, Jocasta
AU  - Ball J
FAU - Lewinter, Christian
AU  - Lewinter C
FAU - Cullington, Damien
AU  - Cullington D
FAU - Stewart, Simon
AU  - Stewart S
FAU - Cleland, John Gf
AU  - Cleland JG
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20100804
PL  - England
TA  - Cochrane Database Syst Rev
JT  - The Cochrane database of systematic reviews
JID - 100909747
SB  - IM
CIN - Evid Based Nurs. 2011 Jan;14(1):27-8. PMID: 21163801
CIN - Cochrane Database Syst Rev. 2011;2011:ED000008. PMID: 21833931
CIN - Cochrane Database Syst Rev. 2012;8:ED000009. PMID: 22895912
UIN - Cochrane Database Syst Rev. 2015;10:CD007228. PMID: 26517969
MH  - Aged
MH  - Chronic Disease
MH  - Heart Failure/mortality/*therapy
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Quality of Life
MH  - Randomized Controlled Trials as Topic
MH  - Telemetry/*methods
MH  - *Telephone
RF  - 315
EDAT- 2010/08/06 06:00
MHDA- 2010/08/26 06:00
CRDT- 2010/08/06 06:00
PHST- 2010/08/06 06:00 [entrez]
PHST- 2010/08/06 06:00 [pubmed]
PHST- 2010/08/26 06:00 [medline]
AID - 10.1002/14651858.CD007228.pub2 [doi]
PST - epublish
SO  - Cochrane Database Syst Rev. 2010 Aug 4;(8):CD007228. doi: 
      10.1002/14651858.CD007228.pub2.