Research: Remote monitoring no better than usual care for heart failure patients

Remote monitoring failed to reduce hospitalizations or death in heart failure patients with implanted electronic devices, according to two studies presented early this week at the European Society of Cardiology Congress 2016.

The Remote Management of Heart Failure Using Implantable Electronic Devices (REM-HF) trial covered 1,650 hospital patients who had cardiac implantable electronic devices.

The patients were divided into two groups: usual care, which included remote monitoring three to six times a month plus usual heart failure follow-up, or consistent remote monitoring sent to the doctor weekly. The median follow-up period lasted 2.8 years, according to an announcement.

There was little difference between the groups.

“The assumption that ‘more data improves outcomes’ is not true,” Martin R. Cowie, M.D., from Imperial College London, co-principal investigator of the study, said in the announcement.  “If patients are well-treated already, and have well-controlled symptoms, looking at remotely collected data weekly is no better than usual care.”

In the second study, called Monitoring Resynchronization Devices And Cardiac Patients (MORE-CARE), 900 heart failure patients with an implanted device were randomized to receive remote monitoring alternating with in-office visits or to have all follow-up done in-office.

At 24 months, there was no significant difference in the groups’ rate of mortality or hospitalization for cardiovascular or device-related reasons.

That study ended early because of slow recruitment, but did find a 41 percent cost savings due to fewer office visits.

The findings run counter to a four-month trial at Massachusetts General Hospital and research in Australia that found similar monitoring reduced hospitalizations and mortality. A European multicenter clinical trial, however, also found remote monitoring to be a cost-effective follow-up strategy.