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Telehealth for Patients with Cardiovascular Disease: A Review of the Clinical Effectiveness, Cost-effectiveness and Guidelines

Published on: January 27, 2016
Project Number: RC0749-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical evidence regarding telehealth interventions for patients with hypertension, coronary artery disease (CAD), or implantable cardiac devices requiring cardiac care?
  2. What is the cost-effectiveness of telehealth interventions for patients with hypertension, CAD, or implantable cardiac devices requiring cardiac care?
  3. What are the evidence-based guidelines regarding telehealth interventions for patients with hypertension, CAD, or implantable cardiac devices requiring cardiac care?

Key Message

Telemonitoring of blood pressure costs more than usual care, but it may represent an useful tool for hypertension control by improving blood pressure and increasing the chances for patients to achieve blood pressure normalization. There was no evidence available on the cost-effectiveness of telemonitoring in patients with CAD requiring cardiac rehabilitation, but telehealth interventions do not have inferior outcomes compared to center-based supervised programs, and telephone support may reduce hospitalizations and reduce risk factors for heart disease. For patients with heart diseases requiring implantable cardiac devices, the costs of telemonitoring were lower than conventional hospital monitoring. Pacemaker telemonitoring led to earlier cardiovascular event detection, with a reduction in hospital visits and hospitalizations. Telemonitoring of implantable cardioverter-defibrillators had similar outcomes compared to in-office follow-up. A Canadian position statement recommends that remote monitoring should be available at all device follow-up clinics as an integral part of the standard of care of device patients with cardiovascular implantable electronic devices.

Tags

blood pressure, cardiac resynchronization therapy, cardiac resynchronization therapy devices, coronary artery disease, defibrillators, heart diseases, hypertension, teleconsultation, telehealth, telemedicine, Artificial, High blood pressure, Pacemaker, Telecare, Teleconsult, Telemonitor, Telemonitoring, hypertensive, tele cardiology, tele-health, tele-medicine