Remote Patient Monitoring in Heart Failure: A Comprehensive Meta-Analysis of Effective Programme Components for Hospitalization and Mortality Reduction

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Abstract
Aims: Methods of non-invasive remote patient monitoring (RPM) for heart failure (HF) remain diverse. Understanding factors that influence the effectiveness of RPM on HF-related and all-cause hospitalizations, mortality, and emergency department visits is crucial for developing successful RPM interventions. This meta-analysis aims to synthesize and compare existing literature on RPM components that impact HF-related and all-cause hospitalizations, mortality and emergency department visits in HF patients. Methods and results: A systematic search of electronic databases (PubMed, EMBASE, CENTRAL) identified randomized controlled trials from January 2012 to June 2023, comparing non-invasive RPM interventions for HF with usual care. A random-effects meta-analysis assessed outcomes, and additional analyses identified effective RPM components. A total of 41 studies with 16 312 patients (mean follow-up: 9.88 ± 6.37 months) were included. RPM was associated with lower mortality risk (pooled odds ratio [OR] 0.81 95% confidence interval [CI] 0.69–0.95; I2 = 0.39) and reduced first HF hospitalization risk (pooled OR 0.78, 95% CI: 0.70–0.87; I2 = 0.21) compared to usual care. RPM interventions with a self-management module (p < 0.001) and education module (p = 0.028) significantly lowered HF-related hospitalizations. Video calls during RPM interventions further reduced HF-related (p = 0.047) and all-cause hospitalizations (p < 0.001). Conclusion: This meta-analysis confirms the efficacy of RPM in reducing HF-related hospitalizations and mortality. Effective components include self-management, education modules, and video communication. However, heterogeneity among interventions challenges the overall evaluation. Modernizing RPM with advanced technologies like non-invasive sensors, artificial intelligence, and cardiac telerehabilitation could enhance its potential.

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