Is age a factor in the success or failure of remote monitoring in heart failure? Telemonitoring and structured telephone support in elderly heart failure patients

Inglis, S. C., Conway, A., Cleland, J. G.F. and Clark, R. A. (2015) Is age a factor in the success or failure of remote monitoring in heart failure? Telemonitoring and structured telephone support in elderly heart failure patients. European Journal of Cardiovascular Nursing, 14(3), pp. 248-255. (doi:10.1177/1474515114530611) (PMID:24681423)

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Abstract

Background: There are few data regarding the effectiveness of remote monitoring for older people with heart failure. We conducted a post-hoc sub-analysis of a previously published large Cochrane systematic review and meta-analysis of relevant randomized controlled trials to determine whether structured telephone support and telemonitoring were effective in this population. Methods: A post hoc sub-analysis of a systematic review and meta-analysis that applied the Cochrane methodology was conducted. Meta-analyses of all-cause mortality, all-cause hospitalizations and heart failure-related hospitalizations were performed for studies where the mean or median age of participants was 70 or more years. Results: The mean or median age of participants was 70 or more years in eight of the 16 (n=2659/5613; 47%) structured telephone support studies and four of the 11 (n=894/2710; 33%) telemonitoring studies. Structured telephone support (RR 0.80; 95% CI=0.63–1.00) and telemonitoring (RR 0.56; 95% CI=0.41–0.76) interventions reduced mortality. Structured telephone support interventions reduced heart failure-related hospitalizations (RR 0.81; 95% CI=0.67–0.99). Conclusion: Despite a systematic bias towards recruitment of individuals younger than the epidemiological average into the randomized controlled trials, older people with heart failure did benefit from structured telephone support and telemonitoring. These post-hoc sub-analysis results were similar to overall effects observed in the main metaanalysis. While further research is required to confirm these observational findings, the evidence at hand indicates that discrimination by age alone may be not be appropriate when inviting participation in a remote monitoring service for heart failure.

Item Type:Articles
Additional Information:SCI has been supported by the National Health and Medical Research Council (NHMRC) and the Heart Foundation of Australia (NHMRC Grant ID 472699) and is currently supported by the Heart Foundation of Australia and the New South Wales Office for Medical Research Cardiovascular Life Sciences Research Fellowship (CR 11S 6226). RAC was a Post-Doctoral Research Fellow supported by the NHMRC (NHMRC Grant ID 570 141) and a Research SA Fellowship.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Inglis, Dr Sally and Cleland, Professor John
Authors: Inglis, S. C., Conway, A., Cleland, J. G.F., and Clark, R. A.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:European Journal of Cardiovascular Nursing
Publisher:SAGE Publications
ISSN:1474-5151
ISSN (Online):1873-1953
Published Online:29 March 2014

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