Table 2.

Possible explanations about failure of large multi-centre trials to demonstrate any benefit from home telemonitoring in heart failure patients

In the study design, TM was treated like a drug, when it is simply a way of improving communication among patients and healthcare providers. None of the trials reported data about the responses to alerts and the type of interventions adopted to solve relevant problems. The follow-up was very short (6–12 months) for multi-centre studies using new technologies. The choice of physiological indicators could have been inadequate. TM relied mainly on patient-initiated communication, and this may have led to an underuse of the system particularly with no adequate feedback. Low adherence to TM systems. TM may be ineffective when not integrated within a HF programme and in absence of individualised alerting algorithms.

HF, heart failure; TM, telemedicine.