Table 1.
Contexts and characteristics of the studies included in the review
| First author, year (country) | Sample size and mean/median age (Intervention) | Sample size and mean/median age (Control) | RPM technology deployed and intervention components | Control | Duration of the intervention | Target condition or disease | Outcomes |
|---|---|---|---|---|---|---|---|
| Ahmed et al.24 (US) | N = 49; mean age = 29.9 | N = 57; mean age = 29.2 | An online, interactive, breastfeeding monitoring system to record breastfeeding and infant output as well as educational resources. | Standard hospital protocol. | 1 month | Postpartum women | 1°: Breastfeeding rates, 2°: Postpartum depression symptom scores. |
| Bernocchi et al.39 (Italy) | N = 56; mean age = 71.0 | N = 56; mean age = 70.0 | An integrated telerehabilitation home-based programme (Telerehab- HBP). The Telerehab-HBP included remote monitoring of cardiorespiratory parameters, weekly phone-calls by the nurse, and exercise programme, monitored weekly by the physiotherapist. | Standard care programme including medications and oxygen prescription, visits from the general practitioner, and in-hospital check-ups on demand. | 4 months | Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) |
1°: Six-minute walking test 2°: Median time to hospitalisation/death, dyspnoea, physical activity profile, disability and quality of life. |
| Blasco et al.35 (Spain) | N = 102; mean age = 60.6 | N = 101; mean age = 61.0 | Remote monitoring using an automatic sphygmomanometer, a glucose and lipid metre and a cellular phone, regular platform monitoring by cardiologist, individualised short text messaging with recommendations to the patients and lifestyle counselling. | Standard care and lifestyle counselling. | 12 months | Acute coronary syndrome (ACS) |
1°: Treatment goals for blood pressure 2°: Smoking cessation and body mass index. |
| Boriani et al.22 (France, Italy, Spain, Switzerland) | N = 76; mean age = 67.0 | N = 72; mean age = 68.0 | Remote monitoring using CareLink Network (A platform for remote monitoring of implantable cardiac devices, which consists of implantable devices provided with wireless telemetry), CareLink monitor (CLM), and the CareLink website (CW). | Standard care (follow-up without alerts). | 12 months | Advanced heart failure |
1°: In-hospital visits, 2°: Annual rate of all-cause hospitalisations. |
| Bouwsma et al.25 (The Netherlands) | N = 227; mean age = 46.0 | N = 208; mean age = 45.6 | Remote monitoring using a web portal with tailored personalised convalescence advice. | Standard care. | Unspecified | Women undergoing hysterectomy |
1°: Duration until full sustainable return to work 2°: The degree of implementation of the care programme was evaluated at the level of the patient, healthcare provider and organisation. |
| da Silva Schultz et al.41 (Brazil) | N = 21; mean age = 69.2 | N = 22; mean age = 69.5 | Five telehealth sessions: Telephone follow-up, from a researcher on the 4th, 8th, 12th, 18th and 25th postoperative day. | Standard care. | 1 month | Laparoscopic cholecystectomy and hernia repair | 1°: Postponed return to work, difficult to move fatigue, perception of recovery, evidence of interrupted healing in surgical site, loss of appetite with nausea, need help to complete self-care, pain, and postoperative sensation. |
| DeVito Dabbs et al.49 (US) | N = 99; mean age = 62.0 | N = 102; mean age = 62.0 | A smartphone with custom Pocket PATH programmes to record daily health indicators, graphical displays of trends, and automatic feedback messages advising them to notify the transplant coordinator if health indicators were critical (outside the pre-established parameters) and a toll-free, tech-help line was available. | Standard care (patient education). | 12 months | Lung transplant |
1°: Self-management behaviour 2°: Self-care agency, rehospitalization, and mortality at home during the first year after transplantation |
| Ebert et al.36 (Germany) | N = 200; mean age = 45.0 | N = 200; mean age = 45.0 | A transdiagnostic Internet-based maintenance treatment: a self-management module, asynchronous patient-coach communication, online patient support group, and online- based monitoring of psychopathological symptoms. | Standard hospital protocol. | 3 months | Affective, neurotic, and/or behavioural disorders |
1°: General psychopathological symptom severity (GPS) 2°: Psychological well-being, depressive symptoms, somatoform complaints, phobic anxiety, interpersonal difficulties, self-efficacy, positive and negative affect, and emotion regulation skills |
| Fang et al.40 (China) | N = 33; mean age = 60.2 | N = 34; mean age = 61.6 | Real-time physiological monitoring using a belt strap with a sensor, a smartphone with an application, computer servers and a web portal, booklet given to the participants, weekly phone calls by a physical therapist, and two home visits by a physical therapist. | Standard care (paper-based and self-study CHD booklet and a biweekly outpatient review). | 1.5 months | Coronary Heart Disease (CHD) | 1°: Six-minute walking test, general health-related quality of life, Fagerstrom Test for Nicotine Dependence, Depression in cardiac patients |
| Gallagher et al.38 (US) | N = 20; mean age = 58.0 | N = 20; mean age = 62.0 | A smart phone application and a web portal: A GlowCap® system which includes a pill bottle cap that records the date and time when the bottle is opened (data were sent to the communication hub). Adherence data were reviewed by a licensed clinical social worker on a daily basis during the first 7 days after discharge and weekly thereafter, participants who were non-adherent for two or more days per week were contacted. | Passive monitoring (adherence data were recorded but not actively monitored by the study team). | 1 month | Heart failure | 1°: Median correct dosing adherence, readmission within 30 days |
| Geramita et al.27 (US) | N = 47; mean age = 56.2 | N = 58; mean age = 56.0 | A smartphone with the Pocket PATH application to set reminders for medication-taking and appointments, and record and view graphs for the health indicators that the transplant programme required them to monitor. If health indicator values fell beyond pre-established ranges, Pocket PATH provided decision-support messages instructing them to contact their transplant coordinator. | Standard care. | 12 months | Lung transplant | 1°: Nonadherence rates in the past month for self-care and lifestyle requirement, nonadherence rates for immunosuppressants and other medications, tobacco use, clinic appointment nonadherence in the past year |
| Graetz et al.26 (US) | N = 14; mean age = 56.3 | N = 15; mean age = 52.9 | Smart phone application with daily reminders during the first week post-discharge, every other day for the second week, and once per week in the 3rd and 4th week post-discharge. App contained discharge instructions and symptom tracking, with triggers sent to the clinical team if symptoms were concerning. | Standard care. | 1 month | Gynaecological cancer | 1°: Mental health composite score |
| Gray et al.48 (US) | N = 26; mean age = 27.8 weeks | N = 30; mean age = 27.5 weeks | A video conference system with online daily report, messaging centre, baby photos, question & answer, educational and support resources, discharge education, one-time training session on how to use system. | Standard care. | Unspecified | Very low birthweight infants | 1°: Length of stay |
| Guédon-Moreau et al.37 (France) | N = 158; mean age = 61.4 | N = 152; mean age = 59.9 | ICD (equipped with Biotronik Home Monitoring) linked to a wireless communication system, which automatically transmits diagnostic data and trend analyses between the implanted device and the caregiver on a daily basis. | Ambulatory follow-up only. | 27 months | Patients with very low birthweight infants | 1°: Non-hospitalisation costs per patient-year, hospitalisation costs per patient-year |
| Higgins et al.28 (Canada) | N = 36; mean age = 30.1 | N = 36; mean age = 30.3 | Health mobile application through which were patients responded to questions regarding function, pain, and Quality of Recovery.Range of motion measurements were inputted by physiotherapists during private outpatient appointments. In addition, the surgical-site examination was performed via submitted photos on the app. Pre-operative patient education was also provided. | Pre-operative patient education only. | 1.5 months | postoperative anterior cruciate ligament reconstruction | 1°: In person clinic visits within 6 weeks of surgery |
| Hindricks et al.23 (Germany and Czech Republic) | N = 77; mean age = 63.0 | N = 78; mean age = 63.0 | RM (ICD implant linked to HM) capability (Biotronik, Berlin, Germany) combined with automatic transmission of electrogram data with customisable alerts) with 3-month monitoring interval. | RM (ICD implant linked to HM capability combined with automatic transmission of electrogram data with customisable alerts) with 12-month monitoring interval. | 24 months | Patients with implantable cardioverter-defibrillator (ICD) |
1°: Number of unscheduled follow-ups per patient-year, total number of scheduled and unscheduled follow-up visits after the 3-month follow-up 2°: Patients remaining after the 3-month follow up, hospitalisations for all causes, hospitalisations for adverse cardiovascular events, patients with ICD therapy delivery |
| Hisam et al.43 (Pakistan) | N = 80; mean age = 53.7 | N = 80; mean age = 51.7 | Medically supervised cardiac rehabilitation programme using smart phone application in addition to standard post-ACS care. Individualised psychotherapy during the hospital stay, diurnal mobile texting of standardised messages about healthy lifestyle changes through the app. | Standard post ACS care. | 6 months | Acute coronary syndrome | 1°: Health related quality of life |
| Indraratna et al.32 (Australia) | N = 81; mean age = 61.3 | N = 83; mean age = 61.7 | A smart phone application (TCC app) connected to bluetooth peripheral devices: a digital sphygmomanometer, a digital weighing scale, and a fitness band (Xiaomi MiBand 2). Data available to the clinicians. The app provided three weekly educational push notifications to promote healthy behaviour choices. Customisable limits for BP, pulse rate, and weight gain, which trigger alerts. | Standard care. | 6 months | Acute coronary syndrome or heart failure |
1°: Number of readmissions at 30 days 2°: Cardiac rehabilitation attendance, cardiac rehabilitation completion |
| Jakobsen et al.33 (Denmark) | N = 29; mean age = NA | N = 28; mean age = NA | Hospital at home: Touch screen with a Webcam, pulse oximeter, spirometer, thermometer, nebuliser for aerosolized inhalation medication, oxygen compressor, and a medicine box containing antibiotics, prednisone, sedative, beta2 agonists, and anticholinergics. Unscheduled and acute contacts could be made 24/7 by the patient pressing the “call hospital” button on the touch screen. | Standard treatment and care at the hospital. | 6 months | COPD | 1°: Readmission within 180 days |
| Li et al.42 (China) | N = 60; mean age = 58.3 | N = 60; mean age = 60.8 | Videoconferencing (on WeChat app) for post-discharge functional assessment. | Telephone follow-up. | 3 months | Stroke |
1°: Functional status 2°: Feasibility of using intervention, acceptability of intervention |
| Li et al.44 (China) | N = 59; mean age = 49.0 | N = 60; mean age = 51.0 | Unsupervised home-based six-week exercise programme (three to four sessions per week) comprising breathing control and thoracic expansion, aerobic exercise and lower limb muscle strength exercise, delivered via smartphone (ReHab App), and remotely monitored with heart rate telemetry. Weekly teleconsultation with a therapist using WeChat voice calls. | Usual care. | 1.5 months | COVID-19 survivors with complaints of dyspnoea |
1°: Six-minute walking test 2°: Squat time, pulmonary functions health-related quality of life, physical component score, mental component score, perceived dyspnoea |
| Pietrantonio et al.30 (Italy) | N = 56; mean age = NA | N = 54; mean age = NA | Telemonitoring device (WINMEDICAL) which allows continuous, real-time vital signs monitoring, automatic calculation of the NEWS (National Early Warning Score) score, and the creation of a personalised alert system for every single patient through a portable device (tablet or phone), a phone call by a nurse, a visit by the nurse 5 days post discharge, the device was removed after five days if patients are stable, continuous follow-up via phone call until day 30. | Usual care. | 1 month | Internal medicine patients (comprising a wide range of acute, subacute and chronic diseases of different grades and severities) |
1°: Major complications (MC) reduction. 2°: Patients who reached discharge criteria within the 7th day from admission, MC incidence at the conclusion of the standard telemonitoring/clinical monitoring phase, 5 and 30 days after discharge; and conditions predisposing to MC occurrence |
| Riegel et al.47 (US) | N = 62; mean age = 59.5 | N = 68; mean age = 57.3 | Electronic monitoring pill bottle (A Medication Event Monitoring System and financial component (financial reward for medication adherence, deduction of reward for medication non-adherence). | Electronic monitoring pill bottle with no financial compensation. | 3 months | ACS | 1°: Medication adherence |
| Scherr et al.21 (Austria) | N = 54; median age = 67.0 | N = 54; median age = 65.0 | MOBITEL Telemedicine Platform to measure their vital parameters (blood pressure, heart rate, body weight) on a daily basis. | Usual care. | 6 months | Heart failure |
1°: Cardiovascular mortality or re-hospitalisation 2°: Functional status, length of stay during re-hospitalisations, technical parameters (system availability, cumulative transmission). |
| Soh et al.45 (South Korea) | N = 22; mean age = NA | N = 22; mean age = NA | Pharmacological treatment and telemedical surveillance using a smart phone application and dashboard (Go-breath app and Go-breath dashboard). | Usual care. | Unspecified | Gastric cancer |
1°: Incentive spirometer index (ISI) 2°: System usability scale (SUS) |
| Somsiri et al.29 (Thailand) | N = 73; mean age = NA | N = 73; mean age = NA | A telehealth programme using a mobile application and usual care (discharge planning and patient education). | Usual care (discharge planning and patient education). | 1.5 months | Heart failure |
1°: Functional status 2°: Rehospitalization |
| van Goor et al.46 (The Netherlands) | N = 31; mean age = 55.1 | N = 31; mean age = 55.4 | RM of medication and oxygen therapy using a mobile health app and telephone monitoring by medical students supervised by internal medicine consultants. | Usual care (medication and oxygen therapy). | 1 month | Patients hospitalised with COVID-19 |
1°: Number of hospital-free days during the 30 days following randomisation 2°: Health care consumption (index hospital length of stay) during the follow-up period, total duration of care under hospital responsibility, and mortality |
| Weintraub et al.34 (US) | N = 95; mean age = 69.5 | N = 93; mean age = 68.5 | (i) Automated health monitoring technology (comprising a device with measurement and communication components (ie, transmission of body weight, blood pressure, and heart rate via a standard telephone line to a central server)) and heart failure disease management programme (comprising (i) weekly phone calls by the patient’s nurse manager to review clinical status; (2) a weekly conference, consisting of nurse managers from all clinical sites and a designated physician, to review all actively enroled patients; and (3) 24/7 telephone access to a nurse manager. | Standard heart failure disease management programme only. | 3 months | Congestive heart failure | 1°: Hospitalisation |
| Wintrich et al.31 (Germany) | (i) RM with no alerts (N = 149; mean age = 65.7) (ii) RM with appropriate contacting only (N = 113; mean age = 65.8) (iii) RM with inappropriate contacting (N = 243; mean age = 66.6) | N = 497; mean age = 66.0 |
Telehealth monitoring with appropriate reaction to the alerts sent. Appropriate contacts had to meet the following criteria: (1) initial telephone contact within 2 working days after fluid index threshold crossings (FTC), (2) follow-up contacts according to study protocol, and (3) medical intervention initiated after FTC due to cardiac decompensation. |
Telehealth monitoring with no alerts sent. | 18 months | Congestive heart failure | 1°: Cardiovascular death or heart failure hospitalisation |
Notes: RM remote monitoring, HM home monitoring.