Comparative Effectiveness of Complex Telemedicine Support in Prevention of Hospitalizations and Mortality in Patients with Heart Failure: A Systematic Review and Meta-Analysis

Abstract

Heart failure is one of the leading causes of hospitalizations and mortality all over the world. There are literature data about the favorable influence of telemedicine support on mortality and hospitalization rate in patients with heart failure, and thus, the results of different studies are controversial. Aim: To estimate the effect of telemedicine support on hospitalization and mortality in patients with heart failure. Methods: The literature search was conducted in databases Google Scholar, MedLine, Clinical Trials, PubMed, Embase, and Crossref with the following key words: “heart failure”, “telemedicine”, “telemonitoring”, “hospitalisation (hospitalization)”, “mortality”. We included studies that were conducted during the last 10 years. In total, we analyzed 1151 records. After screening, 14 randomized control trials were included in the final analysis. Results: The conducted meta-analysis showed that telemedicine support is accompanied by a decrease in heart failure-related hospitalizations (risk ratio (RR) 0.78 (95% confidence interval (CI) 0.68–0.89)) and a decrease in all-cause mortality (RR 0.84 (95% CI 0.75–0.94)). We did not find a significant association between telemedicine support and all-cause hospitalizations. We did not analyze heart failure-related mortality because of insufficient data. Conclusion: Telemedicine support is accompanied by a decrease in heart failure-related hospitalizations and a decrease in all-cause mortality in patients with heart failure.