Telehealth Impact on Patient Outcome in Heart Failure Patients: A Narrative Synthesis Review

Abstract

Background : Studies have reported significant benefit in the health outcomes in heart failure patients due to Telehealth intervention, yet the actual extent of their impact remains unclear due to varying results across different studies. The review aims to summarize the existing evidence on the impact of Telehealth on patient outcome in HF patients. Method : PubMed, MEDLINE, CINAHL, and Embase databases were searched for studies published between 2013 to 2024, focusing on Telehealth intervention to remotely monitor and manage heart failure patients, with the following endpoints: All cause, Heart failure and cardiovascular disease-related readmission, mortality and hospitalizations, Emergency Department visits, changes in self-care behaviour and quality of life. Identified articles were screened for relevance based on eligibility criteria. Included were studies published in English language, original articles and reviews. Due to heterogeneity among the studies a narrative synthesis approach was used to synthesize and interpret findings from multiple studies. Results : This review includes 54 articles (26 original articles and 28 reviews). Largely studies were conducted in Europe (33%). Telemonitoring with telephone support was the most common mode for posthospitalization follow-ups, where the patients monitored their vital signs and reported their health behaviours and symptoms. There is mixed evidence with regards to the impact of Telehealth on health outcomes in heart failure patients. However, majority of the studies have demonstrated considerable improvement in the heart failure knowledge, self-care behaviour and health-related quality of life, as well as reductions in mortality, hospitalizations, and length of hospital stays due to Telehealth intervention. There is also lack of evidence on how long the effectiveness lasts, with studies showing improvement for the short term, the effect did not sustain for a longer time after the intervention was discontinued. To better understand the impact of the Telehealth on patient’s outcome, it is recommended that the future studies evaluate long-term adherence and efficiency of Telehealth post intervention with follow-up for an extensive period. Conclusion : Despite the potential of Telehealth interventions in improving patient outcomes, its effectiveness can vary based on the type of intervention used, patient population and study design, which highlights the need for optimization of Telehealth programs.