Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Where We Are Indexed
Past Issue Archives
Clinical Communication
CME
Outcomes
Research
In Review
Editorial Board
Information for Authors
Author Form

Reprints, Permissions, & Copyright
Site Map
 
JCOM
BACK ISSUE articles are $15 each.
 
International credit cards NOT accepted.



JCOM Paid Subscribers
LOG IN
user name:
password:
 
Forgot password?

JCOM Abstract


J Clin Outcomes Manage 
2005 Apr;12(4):207-217
Heart failure disease management incorporating telemedicine: a critical review
Jerant AF, Nesbitt TS

Abstract Objectives: To summarize and critically review research regarding heart failure disease management (HFDM) programs incorporating telemedicine and to outline critical research gaps and approaches for addressing them. Methods: We searched MEDLINE and other databases for randomized controlled trials (RCTs) and systematic reviews published between 1966 and November 2004 comparing HFDM programs incorporating telemedicine with usual care. Broad definitions of disease management and telemedicine were employed to guide decisions regarding article inclusion. Results: We retrieved 5 prior systematic reviews on this topic, each employing different definitions of disease management and telemedicine, and 33 RCTs. Thirty of the RCTs were included in at least 1 of these reviews, and we found 3 additional RCTs not included in any of them. Considered together, the findings of the 33 RCTs suggest that, when targeted to recently hospitalized patients with moderate to severe heart failure, a variety of HFDM interventions incorporating telemedicine significantly reduced hospitalizations and emergency visits. Fewer studies examined the impact of HFDM programs on mortality, care costs, and quality of life, and their findings varied. Several RCTs targeted patients with less severe disease and/or enrolled in health systems with preexisting proactive approaches to chronic disease care and found no significant improvement in any outcomes. Conclusions: HFDM programs incorporating telemedicine can reduce acute care utilization by severely affected patients, but their impact on other outcomes is unproven. Less symptomatic patients and those cared for in well-organized health systems do not appear to benefit from HFDM. Many questions regarding HFDM remain, such as which program elements are most effective. We propose a HFDM taxonomy to help organize future research on this topic.

Review

Search the Turner White index to find abstracts of articles published in JCOM.





New issues are posted one month following publication of the printed journal.



View past issue archives:    2013    2012    2011    2010    2009    2008    2007
   2006    2005    2004    2003     2002     2001     2000     1999



Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2014, Turner White Communications
Updated 1/20/14 • jdw