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Interactive remote patient monitoring devices for managing chronic health conditions: systematic review and meta-analysis

Leo, DG, Buckley, BJR, Chowdhury, M, Harrison, SL, Isanejad, M, Lip, GYH, Wright, DJ and Lane, DA Interactive remote patient monitoring devices for managing chronic health conditions: systematic review and meta-analysis. Journal of Medical Internet Research. ISSN 1438-8871 (Accepted)

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Abstract

Background: Telemedicine is an expanding and feasible approach to improve medical care for patients with long-term conditions. However, there is a poor understanding of patients’ acceptability of this intervention and their rate of uptake.
Objective: To systematically review the current evidence on telemonitoring in the management of patients with long-term conditions, and to evaluate the patients’ uptake and acceptability of this technology.
Methods: MEDLINE, SCOPUS, and CENTRAL were searched from date of inception to 5 February 2021, with no language restrictions. Studies were eligible for inclusion if they reported any of the following outcomes: (i) intervention uptake and adherence; (ii) study retention; (iii) patient acceptability, satisfaction and experience using intervention: (iv) changes in physiological values; (v) all-cause and cardiovascular related hospitalization; (vi) all-cause and disease specific mortality; (vii) patient-reported outcome measures; (viii) quality of life. Two reviewers independently assessed articles for eligibility.
Results: Ninety-six studies studies were included and fifty-eight were pooled for meta-analyses. Meta-analyses showed reduction in mortality (RR= 0.71, 95% CI 0.56 to 0.89, P=0.003, I2=0%); and improvements in BP (MD -3.85 mmHg, 95% CI -7.03 to -0.68, P<.02, I2= 100%) and HbA1c (MD -0.33, 95% CI -0.57 to -0.09, P=.008, I2= 99%); but no significant improvements in quality of life (MD 1.45, 95% CI -0.10 to 3, P=.07, I2=80%); and increased risk of hospitalization (RR 1.02, 95% CI 0.85 to 1.23, P=.81, I2=79%) with telemonitoring compared to usual care. Twelve studies reported adherence outcomes and nine on satisfaction/acceptance, however heterogeneity in the assessment methods meant meta-analysis could not be performed.
Conclusion: Telemonitoring is a valid alternative to usual care, reducing mortality and improving self-management of the disease, with patients reporting good satisfaction and adherence. Further studies are required to address some potential concerns regarding higher hospitalisation rates and a lack of a positive impact on patients’ quality of life.
This systematic review was registered on PROSPERO (CRD42021236291).

Item Type: Article
Uncontrolled Keywords: 08 Information and Computing Sciences; 11 Medical and Health Sciences; 17 Psychology and Cognitive Sciences; Medical Informatics
Subjects: R Medicine > R Medicine (General)
R Medicine > RM Therapeutics. Pharmacology
Divisions: Sport & Exercise Sciences
Publisher: JMIR Publications
SWORD Depositor: A Symplectic
Date Deposited: 12 May 2022 10:34
Last Modified: 12 May 2022 10:45
URI: https://researchonline.ljmu.ac.uk/id/eprint/16816

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