journal article·2024-08-29Open access

Key Factors for a Successful Telemedicine Solution for Cardiovascular Diseases: A Systematic Review

Giuseppe Felice Russo, Ilaria Basile, Mario Ciampi, Stefano Silvestri

Applied Sciences· Volume 14· Issue 17

Abstract

Background: Telemonitoring systems in cardiology have shown potential in improving chronic cardiovascular disease (CVD) management. This study aims to evaluate the impact of telemonitoring, mainly through mobile applications, on patient outcomes such as self-care, blood pressure control, quality of life, and hospitalization. Methods: We systematically reviewed studies assessing telemonitoring methods for patients with chronic CVD. The analysis included studies from various geographic regions and healthcare settings, focusing on qualitative outcomes without performing a meta-analysis. Results: Telemonitoring was found to aid in maintaining blood pressure and significantly enhance self-care abilities. Improvements in quality of life were observed in some studies, though results varied. Most studies indicated telemonitoring could effectively manage blood pressure and reduce hypertension-related complications. However, the heterogeneity of interventions and outcomes measured across trials posed challenges for a comprehensive meta-analysis. Conclusions: Integrating telemonitoring systems into routine care can significantly improve disease management and patient outcomes for chronic CVD patients. Future research should standardize telemonitoring interventions and outcome measures, conduct long-term studies, and evaluate the cost-effectiveness of these systems. Greater blindness in future randomized controlled trials and more studies on atrial fibrillation are also necessary. Significant potential exists for telemonitoring to improve patient outcomes and assist in managing chronic illnesses.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Blood Pressure and Hypertension Studies · Cardiac Health and Mental Health · Telemedicine and Telehealth Implementation

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Institute for High Performance Computing and Networking, National Research Council of Italy (ICAR-CNR), Via Pietro Castellino 111, 80131 Naples, Italy

Funding

European Union—NextGenerationEU—National Recovery and Resilience Plan (Piano Nazionale di Ripresa e Resilienza, PNRR)

References (60)

Show source-provided references
1. Efficacy of telemedicine for the management of cardiovascular disease: A systematic review and meta-analysis10.1016/S2589-7500(22)00124-8 ↗
2. On the definition and evaluation of telemedicine10.1089/tmj.1.1995.1.19 ↗
3. Effectiveness of mobile telemonitoring applications in heart failure patients: Systematic review of literature and meta-analysis
4. Interactive Remote Patient Monitoring Devices for Managing Chronic Health Conditions: Systematic Review and Meta-analysis10.2196/35508 ↗
5. Expanding the definition and classification of hypertension10.1111/j.1524-6175.2005.04769.x ↗
6. Universal definition and classification of heart failure: A report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure10.1002/ejhf.2115 ↗
7. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC10.1093/eurheartj/ehab368 ↗
8. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC10.1093/eurheartj/ehaa612 ↗
9. Kędzierski, K., Radziejewska, J., Sławuta, A., Wawrzyńska, M., and Arkowski, J. (2022). Telemedicine in Cardiology: Modern Technologies to Improve Cardiovascular Patients’ Outcomes—A Narrative Review. Medicina, 58.10.3390/medicina58020210 ↗
10. Utility of telemedicine in the COVID-19 era10.31083/j.rcm.2020.04.188 ↗
11. Chronic disease management in heart failure: Focus on telemedicine and remote monitoring10.31083/j.rcm2202046 ↗
12. Choi, W.S., Kim, N.S., Kim, A.Y., and Woo, H.S. (2021). Nurse-Coordinated Blood Pressure Telemonitoring for Urban Hypertensive Patients: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health, 18.10.3390/ijerph18136892 ↗
13. Impact of blood pressure telemonitoring on hypertension outcomes: A literature review10.1089/tmj.2010.0015 ↗
14. Effectiveness of home blood pressure telemonitoring: A systematic review and meta-analysis of randomised controlled studies10.1038/jhh.2016.99 ↗
15. Effectiveness of telemonitoring on self-care behaviors among community-dwelling adults with heart failure: A quantitative systematic review10.11124/JBIES-20-00329 ↗
16. Self-care management and experiences of using telemonitoring as support when living with hypertension or heart failure: A descriptive qualitative study10.1016/j.ijnsa.2023.100149 ↗
17. Telemedicine for healthcare: Capabilities, features, barriers, and applications10.1016/j.sintl.2021.100117 ↗
18. Ciampi, M., Sicuranza, M., and Silvestri, S. (2022). A Privacy-Preserving and Standard-Based Architecture for Secondary Use of Clinical Data. Information, 13.10.3390/info13020087 ↗
19. Cyber threat assessment and management for securing healthcare ecosystems using natural language processing10.1007/s10207-023-00769-w ↗
20. Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., and Group, T.P. (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med., 6.10.1371/journal.pmed.1000097 ↗
21. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews10.1136/bmj.n71 ↗
22. A 24-step guide on how to design, conduct, and successfully publish a systematic review and meta-analysis in medical research10.1007/s10654-019-00576-5 ↗
23. Álvarez Hernández, S., Castillo, D., Villa-Vicente, J.G., Yanci, J., Marqués-Jiménez, D., and Rodríguez-Fernández, A. (2024). Analyses of Physical and Physiological Responses during Competition in Para-Footballers with Cerebral Palsy: A Systematic Review. Appl. Sci., 14.10.3390/app14093812 ↗
24. Schardt, C., Adams, M.B., Owens, T., Keitz, S., and Fontelo, P. (2007). Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med. Inform. Decis. Mak., 7.10.1186/1472-6947-7-16 ↗
25. COVID-19 transforms health care through telemedicine: Evidence from the field10.1093/jamia/ocaa072 ↗
26. The worldwide impact of telemedicine during COVID-19: Current evidence and recommendations for the future
27. Implementation and Usefulness of Telemedicine During the COVID-19 Pandemic: A Scoping Review10.1177/2150132720980612 ↗
28. (2024, August 21). Cochrane Methods Bias. RoB 2: A Revised Cochrane Risk-of-Bias Tool for Randomized Trials. Available online: https://methods.cochrane.org/bias/resources/rob-2-revised-cochrane-risk-bias-tool-randomized-trials.
29. RoB 2: A revised tool for assessing risk of bias in randomised trials10.1136/bmj.l4898 ↗
30. Di Francesco, F., Lanza, A., Di Blasio, M., Vaienti, B., Cafferata, E.A., Cervino, G., Cicciù, M., and Minervini, G. (2022). Application of Botulinum Toxin in Temporomandibular Disorders: A Systematic Review of Randomized Controlled Trials (RCTs). Appl. Sci., 12.10.3390/app122312409 ↗
31. PERson-centredness in Hypertension management using Information Technology: A randomized controlled trial in primary care
32. The effect of the mobile “blood pressure management application” on hypertension self-management enhancement: A randomized controlled trial10.1186/s13063-021-05270-0 ↗
33. Choi, E.Y., Park, J.S., Min, D.L., Ahn, S., and Ahn, J.A. (2023). Heart Failure-Smart Life: A randomized controlled trial of a mobile app for self-management in patients with heart failure. BMC Cardiovasc. Disord., 23.10.1186/s12872-023-03039-8 ↗
34. The impact of telehealth care on health-related quality of life of patients with heart failure: Results from the Danish TeleCare North heart failure trial10.1177/1357633X19832713 ↗
35. Clays, E., Puddu, P.E., Luštrek, M., Pioggia, G., Derboven, J., Vrana, M., De Sutter, J., Le Donne, R., Baert, A., and Bohanec, M. (2021). Proof-of-concept trial results of the HeartMan mobile personal health system for self-management in congestive heart failure. Sci. Rep., 11.10.1038/s41598-021-84920-4 ↗
36. The Effects of Telemonitoring on Patient Compliance With Self-Management Recommendations and Outcomes of the Innovative Telemonitoring Enhanced Care Program for Chronic Heart Failure: Randomized Controlled Trial10.2196/17559 ↗
37. Hypertension and mobile application for self-care, self-efficacy and related knowledge10.1093/her/cyac012 ↗
38. TensioBot: A Chatbot Assistant for Self-Managed in-House Blood Pressure Checking10.1007/s10916-021-01730-x ↗
39. Mobile Health Technology to Improve Care for Patients With Atrial Fibrillation10.1016/j.jacc.2020.01.052 ↗
40. The effectiveness of a nurse-led home-based heart failure self-management programme (the HOM-HEMP) for patients with chronic heart failure: A three-arm stratified randomized controlled trial10.1016/j.ijnurstu.2021.104026 ↗
41. Telemonitoring in patients with chronic heart failure and moderate depressed symptoms: Results of the Telemedical Interventional Monitoring in Heart Failure (TIM-HF) study10.1002/ejhf.2025 ↗
42. The usability and effect of an mHealth disease management platform on the quality of life of patients with paroxysmal atrial fibrillation—The emPOWERD-AF study10.1177/14604582221139053 ↗
43. Digital redesign of hypertension management with practice and patient apps for blood pressure control (PIA study): A cluster-randomised controlled trial in general practices10.1016/j.eclinm.2022.101712 ↗
44. Efficacy of an mHealth App to Support Patients’ Self-Management of Hypertension: Randomized Controlled Trial10.2196/43809 ↗
45. Individualized Studies of Triggers of Paroxysmal Atrial Fibrillation: The I-STOP-AFib Randomized Clinical Trial10.1001/jamacardio.2021.5010 ↗
46. Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: Randomised controlled trial10.1136/bmj.m4858 ↗
47. Effect of Home Blood Pressure Telemonitoring Plus Additional Support on Blood Pressure Control: A Randomized Clinical Trial
48. Self-care Management Intervention in Heart Failure (SMART-HF): A Multicenter Randomized Controlled Trial10.1016/j.cardfail.2021.06.009 ↗
49. The effect of tablet computer-based telemonitoring added to an established telephone disease management program on heart failure hospitalizations: The Specialized Primary and Networked Care in Heart Failure (SPAN-CHF) III Randomized Controlled Trial10.1016/j.ahj.2023.02.007 ↗
50. Non-invasive home telemonitoring system for heart failure patients: A randomized clinical trial10.1177/1357633X19899261 ↗
51. Yuting, Z., Xiaodong, T., and Qun, W. (2023). Effectiveness of a mHealth intervention on hypertension control in a low-resource rural setting: A randomized clinical trial. Front. Public Health, 11.10.3389/fpubh.2023.1049396 ↗
52. Feedback based on health advice via tracing bracelet and smartphone in the management of blood pressure among hypertensive patients: A community-based RCT trial in Chongqing, China10.1097/MD.0000000000029346 ↗
53. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection10.1097/00005650-199206000-00002 ↗
54. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)10.1007/s11136-011-9903-x ↗
55. Assessment of patient outcome with the Minnesota Living with Heart Failure questionnaire: Reliability and validity during a randomized, double-blind, placebo-controlled trial of pimobendan. Pimobendan Multicenter Research Group10.1016/0002-8703(92)90986-6 ↗
56. Development and Validation of the Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) Questionnaire in Patients with Atrial Fibrillation10.1161/CIRCEP.110.958033 ↗
57. A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity10.1097/00005650-199603000-00003 ↗
58. The MacNew Heart Disease health-related quality of life instrument: A summary10.1186/1477-7525-2-50 ↗
59. 2021 European Society of Hypertension practice guidelines for office and out-of-office blood pressure measurement10.1097/HJH.0000000000002843 ↗
60. New York Heart Association functional class predicts exercise parameters in the current era10.1016/j.ahj.2009.07.017 ↗