Telemonitoring in Chronic Heart Failure Among the Elderly: A Rapid Review of Literature.

Abstract

Introduction: Chronic heart failure (HF) is a global health issue, with telemonitoring emerging as a key strategy for elderly patient management, aligning with the Universal Health Care Law.

Objective: To assess the impact of telemonitoring on the quality of life, hospitalization rate, and mortality rate among elderly patients with chronic HF.

Methods: A rapid review of 11 studies, including randomized controlled trials, quasi-experimental, prospective, and retrospective studies from 2013 to 2023, was performed using CINAHL. The studies encompassed 14,993 elderly patients with chronic HF from hospital and homecare settings.

Results: The impact of telemonitoring on quality of life, hospitalization, readmission, and mortality among elderly patients with chronic HF varies widely across studies. Three studies reported quality of life improvements in the intervention group, one showed no significant change, and most studies revealed no difference in all-cause hospitalizations and readmissions between intervention and control groups. Mortality rate comparisons also showed no significant differences.

Discussion: The studies, conducted between 2013 and 2020 primarily in high-income regions, highlight telemonitoring's growing role in managing chronic heart failure (CHF) among elderly patients, yet its global applicability remains limited by a lack of research from Asia and Africa. While telemonitoring systems showed promise in improving patient adherence, engagement, and potentially reducing mortality, their effectiveness on quality of life, hospitalization, and readmission rates is inconsistent, likely influenced by variability in system design and patient characteristics. Limitations such as reliance on a single database, a small number of studies, and underrepresentation of mortality data further constrain the generalizability and conclusiveness of the findings.

Conclusion: Telemonitoring is a complex, yet promising tool for elderly CHF patient management. To enhance care quality and fulfill universal healthcare goals, policymakers and healthcare practitioners should consider these insights to create precise, effective telemonitoring strategies.