August 2010 - Recent journal articles
Mike Clark
A Canadian systematic review of Home Telemonitoring for diabetes, pulmonary diseases and cardiovascular diseases examined 119 studies from 1966 to 2007 and found that the effects of this care delivery approach are highly encouraging at the clinical, behavioral, and structural levels. Patients had a better understanding of their health and clinical effectiveness was evident. 50% of the studies identified reduced service utilisation. The researchers also looked at the requirements for successful implementation. Deployment of technologies alone could not guarantee successful outcomes. They were not able to draw firm conclusions on the economic viability of home telemonitoring and recommended further studies.
Systematic Review of the Effects of Home Telemonitoring in the Context of Diabetes, Pulmonary Diseases and Cardiovascular Diseases (Canadian briefing)
http://www.inahta.org/Publications/Briefs-Checklist-Impact/2009/4417/
2009 publication: http://www.aetmis.gouv.qc.ca/site/en_publications2009.phtml
A second Canadian systematic review of 62 home monitoring studies suggested a trend that better glycaemic control was achieved for diabetics and that improvements in peak expiratory flows were achieved for asthmatics with symptom reduction and quality of life benefits. Home telemonitoring also had a beneficial impact on systolic and diastolic blood pressure. The researchers consider that larger trials were needed to confirm the clinical benefits for heart failure patients.
Clinical Effects of Home Telemonitoring in the Context of Diabetes, Asthma, Heart Failure and Hypertension: A Systematic Review
http://www.jmir.org/2010/2/e21
A third Canadian systematic review of COPD covering a total of 858 patients examined four studies that compared home telemonitoring with usual care and six randomised controlled trials that compared telephone support with usual care. They concluded that home telemonitoring and telephone support reduced hospitalisation rates and emergency department visits. Findings for length of stay varied. The mortality rate was greater in the telephone support group compared with usual care. Telehealth interventions were similar or better than usual care for quality of life and patient satisfaction outcomes.
Home telehealth for chronic obstructive pulmonary disease: a systematic review and meta-analysis
http://jtt.rsmjournals.com/cgi/content/abstract/16/3/120
A recent Spanish study of 92 heart failure patients during 2008/9 suggests that remote monitoring can reduce cardiovascular events, hospital admissions and length of stay. 51 patients were managed by a home monitoring system alone and 41 patients were measured by the home monitoring system and telemonitoring of blood pressure, pulse rate and weight. After a 12-month follow-up, study results showed that the rate of all cardiovascular hospitalisations decreased from 54 cases to 20 cases. There was not a significant reduction in hospitalisations between the groups, however length of stay declined.
Remote monitoring programs reduce admissions, length of stay
http://www.cmio.net/index.php?option=com_articles&view=article&id=22540&division=cmio