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Document Details : Title: A critical review on telemonitoring in heart failure Author(s): O. Gurné , V. Conraads , L. Missault , W. Mullens , J.-L. Vachiery , W. Van Mieghem , W. Droogne , A.-C. Pouleur , P. Troisfontaine , S. Huez , E. Nellessens , B. Peperstraete , P. Blouard , J. Vanhaecke , D. Raes Journal: Acta Cardiologica Volume: 67 Issue: 4 Date: 2012 Pages: 439-444 DOI: 10.2143/AC.67.4.2170685 Abstract : Morbidity and mortality remain high in heart failure despite considerable progress achieved with medical therapy and electrical devices. A multidisciplinary approach is actually strongly recommended. In order to provide optimal care to the ever-growing population of patients with heart failure, telemonitoring has been proposed as a modality to improve usual care. The aim of this review is to provide an overview of the existing evidence on telemonitoring in HF. Despite two major meta-analyses with favourable results, two recent, large, multicentre, randomized controlled trials, one with a sophisticated technical remote telemonitoring approach (TIM-HF) in stable chronic HF and the other with a comprehensive telephone-based interactive voice-response monitoring (Tele-HF) in patients recently hospitalized for heart failure, have been performed and both failed to demonstrate a clinical benefit for telemonitoring. Newer technologies or other modalities, such as collaboration between a general practitioner and a heart failure clinic facilitated by telemonitoring should be further evaluated. Dedicated telemonitoring for heart failure may be a practical adjunct in selective centres and patients, on top of usual care, including education and a multidisciplinary approach. However, prior to being accepted as a standard of care, more evidence from large, randomized clinical trials is required. |
