Result card

  • CUR4: Is Structured telephone support (STS) for adult patients with chronic heart failure a new, innovative mode of care, an add-on to or modification of a standard mode of care or replacement of a standard mode of care?
English

Is Structured telephone support (STS) for adult patients with chronic heart failure a new, innovative mode of care, an add-on to or modification of a standard mode of care or replacement of a standard mode of care?

Authors: Ingrid Wilbacher, Nadine Berndt, Francesca Gillespie

Internal reviewers: Alessandra Lo Scalzo, Christian Vladescu, Christina Mototolea, Kristina Lampe, Maria Camerlingo

Eleven studies out of the basic literature search and one study from an additional handsearch provided information to answer this question.

Generally, telemedicine and telemonitoring can be seen as relatively new, currently as an adjunct to current care with the chance of more patient-self-care-involvement and improved quality of therapeutic monitoring, but without a clear unique idea where it should lead to and how it should be implemented.

One of the included studies provides a historical overview of the published studies, starting with 1987, growing in the late 1990s, but most published after 2000, mainly from the US. The study mentions that: „The data show that home telemonitoring programmes have appeared quite recently. Even though the first study on this subject was published in 1987, most early projects to be described in the literature began to appear in the early 1990s. Studies published between 1991 and 1995 represent 6 % of the total sample. The number of published studies then grew in the second half of the decade (1996 to 1999), representing 15 % of the sample. The number then increased significantly: more than three quarters of the studies in the sample were published after 2000. The data also show that 45 % of the studies were carried out in the United States, approximately a third were conducted in Europe, while 6 % were conducted in Asia and in Canada. Finally, almost three quarters of the studies in our sample were RCTs, both small and large.“ {92}, 2010

Giamouzis et al. (2012) describes telemedicine as a novel diagnostic modality in 2012{31};  Sousa et al. as a novel tool {102}, 2014.

Eight of the included reviews try to look at the indicators for novelty and how they lead to a novel attitude – like including the patient - and new settings – like different patient- and physician roles - of health care. They still describe telemedicine as „changing modality“ {15}, „promising“ {91}, 2007, „complementary“ {99}, 2010, „potentially“ {35}, 2011, „a modality to improve care“ {34}, 2012, and a common insecurity about what exactly is defined as telemedicine and what kind of programmes were modified into telemedicine (like disease management programmes which are technically supported) seems to occur. The importance and necessity of individual self-care in the overall HF management is recognized {96}, 2012, but currently only a relatively small proportion of HF patients have access to such programmes {102}, 2014. Telemonitoring moves patient care out of a clinical setting shifting the burden of care to the patient’s home, but also giving the patient enhanced autonomy and control {47} in {95}, 2014.

Remote monitoring is still described as an adjunct to current out-of-hospital management of advanced heart failure {63} and is still not widely adopted due to a number of social, technological and reimbursement issues. Remote monitoring will not replace face-to-face clinical review, but it will be part of the solution to the increasing numbers of patients with heart failure and/or an implantable device.{14}

Important
Partially
Wilbacher I et al. Result Card CUR4 In: Wilbacher I et al. Health Problem and Current Use of the Technology In: Jefferson T, Cerbo M, Vicari N [eds.]. Structured telephone support (STS) for adult patients with chronic heart failure [Core HTA], Agenas - Agenzia nazionale per i servizi sanitari regionali ; 2015. [cited 16 June 2021]. Available from: http://corehta.info/ViewCover.aspx?id=305

References