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      Telemedicine and remote management of patients with heart failure.

      1 , ,
      Lancet (London, England)
      Elsevier BV

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          Abstract

          Advances in telecommunication technologies have created new opportunities to provide telemedical care as an adjunct to medical management of patients with heart failure. Meta-analyses suggest that telemedicine can reduce morbidity and mortality in such patients; however, two prospective clinical trials not included in the analyses do not support these findings. Therefore, the effectiveness of telemedicine in heart failure is not established. Telemedicine approaches range from computer-based support systems to programmes led by nurses and physicians. Standardisation and appropriate classification of telemedical systems are needed to enable accurate interpretation of clinical trials. Here we propose a classification of four generations of telemedicine in heart failure. Not all approaches are the same and not every patient with heart failure will need telemedicine. Crisis prevention and treatment, and stabilisation and self-empowerment of patients are focuses of telemedicine in heart failure. The profile of patients who can potentially benefit from telemedicine is unknown and should be investigated in adequately powered randomised clinical trials. We are optimistic that telemedicine is an efficient approach and will become an important feature of management in heart failure.

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          Author and article information

          Journal
          Lancet
          Lancet (London, England)
          Elsevier BV
          1474-547X
          0140-6736
          Aug 20 2011
          : 378
          : 9792
          Affiliations
          [1 ] Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany. s.anker@cachexia.de
          Article
          S0140-6736(11)61229-4
          10.1016/S0140-6736(11)61229-4
          21856487
          fbeb382e-c493-4578-adda-6f6c5ffb84a9
          History

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