Up until now, most studies of remote monitoring programs for patients with congestive heart failure (CHF) have focused on readmission rates. But a new Australian review of 25 studies involving 9,500 patients finds that the use of remote monitoring devices is correlated with a 33 percent drop in mortality rates for patients with CHF. In contrast, nurse monitoring of heart failure patients by telephone was not shown to reduce mortality, although it was linked to lower readmission rates. Both approaches cut overall health costs, the study said.
Performed under the auspices of the international Cochrane Collaboration, the Aussie review found that, with telemonitoring, there were 102 deaths per 1,000 people, compared with 154 deaths per 1,000 among those who received standard care. In the groups that received telephone support, 112 patients per 1,000 died, compared with 127 per 1,000 in the control groups for those studies. The latter difference is not statistically significant.
In telephonic disease management programs for CHF, care managers call patients at home, asking questions about heart rate and rhythm, blood pressure, weight, and diet. While the answers provide key information about each patient's health status, the telemonitoring devices supply more timely data, triggering interventions that more often save patients' lives.
The first such device to be approved by the FDA, the Corventis PiiX, is worn on the skin, costs a few hundred dollars, and delivers data over a cellular network. The sensor includes an impedance detector, allowing fluid buildup in the lungs to be detected before the patient has symptoms. At that point, diuretics can correct the problem, avoiding hospitalizations. An accelerometer in the device also tells doctors whether a patient is sitting up or lying down, which can aid diagnosis.
One reason why the study is important, says Sally Inglis, lead author of the Australian review paper, is that it will give device companies a green light to develop business models for remote monitoring.