Efficacy of telemedicine for the management of cardiovascular disease: a systematic review and meta-analysis

Pei Xuan Kuan, Weng Ken Chan, Denisa Khoo Fern Ying, Mohd Aizuddin Abdul Rahman, Kalaiarasu M Peariasamy, Nai Ming Lai, Nicholas L Mills, Atul Anand

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Telemedicine is increasingly supporting chronic disease management through remote patient monitoring and consultation, particularly during the COVID-19 pandemic. We undertook a systematic review and meta-analysis of studies reporting effectiveness of telemedicine interventions for the management of patients with cardiovascular conditions.

We conducted a systematic search of PubMed, Scopus and the Cochrane Library from inception to 18 January 2021. Two reviewers independently assessed and extracted data from trials, observational and cohort studies that included a telemedicine intervention compared to usual care in cardiovascular disease populations, for outcomes of mortality, hospitalisation and risk factor modification. Study quality was evaluated by Cochrane Risk-of-Bias and Newcastle-Ottawa Scales. The systematic review protocol was registered (PROSPERO CRD42021221010).

72 studies including 127,869 participants met eligibility criteria, with 34 studies included in meta-analysis (n=13,269 with 6,620 receiving telemedicine). Remote monitoring and consultation for heart failure patients was associated with reduced risk of cardiovascular mortality (Risk Ratio [RR] 0·83, 95% Confidence Interval [CI] 0·70–0·99, p=0·04) and hospitalisation for a cardiovascular cause (RR 0·71, 95% CI 0·58–0·87, p=0·001), notably in studies with short-term follow-up. There was no effect of telemedicine on all-cause hospitalisation (RR 1.02, 95% CI 0.94–1.10, p=0.71) or mortality (RR 0.90, 95% CI 0.77–1.06, p=0.23) in these groups, and no benefits were observed with remote consultation in isolation. Small reductions were observed for systolic blood pressure (mean difference –3·59 mmHg, 95% CI –5·35 to –1·83 mmHg, p<0·001) by remote monitoring and consultation in secondary prevention populations, and in body mass index (mean difference –0·38 kg/m2, 95% CI –0·66 to –0·11 kg/m2, p=0·006) by remote consultation in primary prevention settings.

Telemedicine including both remote disease monitoring and consultation may reduce short-term cardiovascular hospitalisation and mortality risk amongst patients with heart failure. Future research should evaluate the sustained effects of telemedicine interventions.

Original languageEnglish
JournalThe Lancet Digital Health
Publication statusPublished - 23 Aug 2022

Keywords / Materials (for Non-textual outputs)

  • Cardiovascular disease
  • digital health
  • Telemedicine


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