A Meta-Analysis of Remote Monitoring of Heart Failure Patients
A Meta-Analysis of Remote Monitoring of Heart Failure Patients
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DOI：
10.1016/j.jacc.2009.08.017
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发表时间：
2009-10-27
影响因子：
24
通讯作者：
Auricchio, Angelo
中科院分区：
文献类型：
--
作者：
Klersy, Catherine;De Silvestri, Annalisa;Auricchio, Angelo
目的本研究的目的是评估远程患者监护（RPM）对慢性心力衰竭（HF）患者预后的影响。背景RPM通过患者和医疗保健提供者之间定期安排的结构化电话联系或使用远程访问技术通过远程外部、可穿戴和可穿戴设备进行生理数据的电子传输来实现。方法回顾2000年1月至2008年10月发表的关于多学科心力衰竭方法的文献，结果随机对照试验和队列研究分别纳入6,258例患者和2,354例患者。随机对照试验的中位随访时间为6个月，队列研究为12个月。随机对照试验和队列研究均显示，RPM与死亡人数显著降低相关（RCT：相对风险[RR]：0.83，95%置信区间[CI]：0.73至0.95，p = 0.006;队列研究：RR：0.53，95% CI：0.29至0.96，p < 0.001）和住院治疗（RCT：RR：0.93，95% CI：0.87至0.99，p = 0.030;队列研究：RR：0.52，95% CI：0.28至0.96，p < 0.001）。事件的减少是更大的队列研究比RCTs.Conclusions RPM赋予一个显着的保护性临床效果，慢性HF患者相比，通常的护理。（J Am科尔心脏病学杂志2009; 54：1683-94）（c）美国心脏病学会基金会2009年
Objectives The purpose of this study was to assess the effect of remote patient monitoring ( RPM) on the outcome of chronic heart failure (HF) patients.Background RPM via regularly scheduled structured telephone contact between patients and health care providers or electronic transfer of physiological data using remote access technology via remote external, wearable, or implantable electronic devices is a growing modality to manage patients with chronic HF.Methods After a review of the literature published between January 2000 and October 2008 on a multidisciplinary heart failure approach by either usual care (in-person visit) or RPM, 96 full-text articles were retrieved: 20 articles reporting randomized controlled trials (RCTs) and 12 reporting cohort studies qualified for a meta-analysis.Results Respectively, 6,258 patients and 2,354 patients were included in RCTs and cohort studies. Median follow-up duration was 6 months for RCTs and 12 months for cohort studies. Both RCTs and cohort studies showed that RPM was associated with a significantly lower number of deaths (RCTs: relative risk [RR]: 0.83, 95% confidence interval [CI]: 0.73 to 0.95, p = 0.006; cohort studies: RR: 0.53, 95% CI: 0.29 to 0.96, p < 0.001) and hospitalizations (RCTs: RR: 0.93, 95% CI: 0.87 to 0.99, p = 0.030; cohort studies: RR: 0.52, 95% CI: 0.28 to 0.96, p < 0.001). The decrease in events was greater in cohort studies than in RCTs.Conclusions RPM confers a significant protective clinical effect in patients with chronic HF compared with usual care. (J Am Coll Cardiol 2009; 54: 1683-94) (c) 2009 by the American College of Cardiology Foundation