Telemonitoring can assist in managing cardiovascular disease in primary care: a systematic review of systematic reviews

BMC Family Practice

Research Article

Elizabeth J Halcomb¹  Renee Purcell²  Susan McInnes³ 

[1] School of Nursing & Midwifery, University of Wollongong, Wollongong, NSW, Australia;School of Nursing and Midwifery, University of Western Sydney, Penrith, NSW, Australia;School of Nursing and Midwifery, University of Western Sydney, Penrith, NSW, Australia;School of Nursing & Midwifery, University of Wollongong, Wollongong, NSW, Australia;

关键词: Systematic review;    Telemonitoring;    Heart failure;    Hypertension;    Primary care;   

DOI  :  10.1186/1471-2296-15-43

 received in 2013-10-30, accepted in 2014-02-07,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThere has been growing interest regarding the impact of telemonitoring and its ability to reduce the increasing burden of chronic diseases, including chronic cardiovascular disease (CVD), on healthcare systems. A number of randomised trials have been undertaken internationally and synthesised into various systematic reviews to establish an evidence base for this model of care. This study sought to synthesise and critically evaluate this large body of evidence to inform clinicians, researchers and policy makers.MethodsA systematic review of systematic reviews investigating the impact of telemonitoring interventions in the primary care management of CVD was conducted. Reviews were included if they explored primary care based telemonitoring in either CVD, heart failure or hypertension, were reported in the English language and were published between 2000 and 2013. Data was extracted by one reviewer and checked by a second reviewer using a standardised form. Two assessors then rated the quality of each review using the Overview Quality Assessment Questionnaire (OQAQ).ResultsOf the 13 included reviews, four focused on telemonitoring interventions in hypertension or CVD management and the remaining 9 reviews investigated telemonitoring in HF management. Seven reviews scored a five or above on the OQAQ evidencing good quality reviews. Findings suggest that telemonitoring can contribute to significant reductions in blood pressure, decreased all-cause and HF related hospitalisations, reduced all-cause mortality and improved quality of life. Telemonitoring was also demonstrated to reduce health care costs and appears acceptable to patients.ConclusionTelemonitoring has the potential to enhance primary care management of CVD by improving patient outcomes and reducing health costs. However, further research needs to explore the specific elements of telemonitoring interventions to determine the relative value of the various elements. Additionally, the ways in which telemonitoring care improves health outcomes needs to be further explored to understand the nature of these interventions.

【 授权许可】

Unknown   
© Purcell et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.