Structured telephone support or non‐invasive telemonitoring for patients with heart failure

Background Specialised disease management programmes for heart failure aim to improve care, clinical outcomes and/or reduce healthcare utilisation. Since the last version of this review in 2010, several new trials of structured telephone support and non‐invasive home telemonitoring have been published which have raised questions about their effectiveness. Objectives To review randomised controlled trials (RCTs) of structured telephone support or non‐invasive home telemonitoring compared to standard practice for people with heart failure, in order to quantify the effects of these interventions over and above usual care. Search methods We updated the searches of the Cochrane Central Register of Controlled Trials (CENTRAL), Database of s of Reviews of Effects (DARE), Health Technology AsseFssment Database (HTA) on the Cochrane Library; MEDLINE (OVID), EMBASE (OVID), CINAHL (EBSCO), Science Citation Index Expanded (SCI‐EXPANDED), Conference Proceedings Citation Index‐ Science (CPCI‐S) on Web of Science (Thomson Reuters), AMED, Proquest Theses and Dissertations, IEEE Xplore and TROVE in January 2015. We handsearched bibliographies of relevant studies and systematic reviews and conference proceedings. We applied no language limits. Selection criteria We included only peer‐reviewed, published RCTs comparing structured telephone support or non‐invasive home telemonitoring to usual care of people with chronic heart failure. The intervention or usual care could not include protocol‐driven home visits or more intensive than usual (typically four to six weeks) clinic follow‐up. Data collection and analysis We present data as risk ratios (RRs) with 95% confidence intervals (CIs). Primary outcomes included all‐cause mortality, all‐cause and heart failure‐related hospitalisations, which we analysed using a fixed‐effect model. Other outcomes included length of stay, health‐related quality of life, heart failure knowledge and self care, acceptability and cost; we described and tabulated these. We performed meta‐regression to assess homogeneity (the null hypothesis) in each subgroup analysis and to see if the effect of the intervention varied according to some quantitative variable (such as year of publication or median age). Main results We include 41 studies of either structured telephone support or non‐invasive home telemonitoring for people with heart failure, of which 17 were new and 24 had been included in the previous Cochrane review. In the current review, 25 studie