Authors' objectives: Home telemonitoring is a telemedicine application in which physiological and biological data are transmitted over a distance for follow-up, interpretation and clinical decision-making purposes. It is a relatively recent and steadily growing intervention modality, not only in many industrialized countries, but also in certain developing countries. It is a means of making health care and services accessible to vulnerable patients where there is a shortage of resources. Given the rise in chronic diseases, the increase in the aging of the population and the policy emphasizing a shift toward ambulatory care, a large number of chronically ill patients in Québec could benefi t from remote home monitoring. The most frequent diseases include diabetes, pulmonary diseases, heart failure and hypertension. In this context, the issue of the effi cacy of such an intervention modality arises. The objective of this systematic review is, therefore, to determine the effects associated with home telemonitoring. These effects will be examined in light of studies that have looked at three main categories of diseases and their associations: diabetes (type 1, type 2 and gestational), pulmonary diseases (asthma and chronic obstructive pulmonary disease) and cardiovascular diseases (heart failure and hypertension). The assessment also explores the conditions for success for this care delivery method.

Authors' results and conclusions: The highly encouraging results observed at the clinical, behavioural and structural levels, together with the demographic changes, the prevalence of chronic diseases and the anticipated shortage of nurses in Québec, warrant the gradual implementation of home telemonitoring for all the health-care services offered to the chronically ill. However, the success of such projects depends, to a large extent, on a holistic view and proactive management of the various issues and risks involved, for the technological devices provided to the patients cannot, by themselves, guarantee that the desired effects will materialize. The likelihood of observing these positive effects can be signifi cantly increased only by meeting all of the conditions for success listed above. However, it will be necessary to confi rm the presumed costeffectiveness of this care delivery method.

Authors' recommendations: Analysis of the 119 identified studies on home telemonitoring reveals that the effects of this care delivery method are, in general, highly encouraging, especially at the clinical, behavioral, and structural levels. In general, telemonitoring is clinically effective in patients with diabetes, hypertension, or asthma and allows for a better understanding of the patient’s health, better control of symptoms, greater compliance with pharmacotherapy, and greater patient empowerment. It also leads to a reduction in demand for health care, with 50% of the studies reporting a significant decrease in service consumption. The other half of the studies report that both modalities (telemonitoring and conventional home follow-up) are equivalent in this regard. The analysis also identified 3 main categories of conditions for successful implementation of telemonitoring: 1) those associated with the patients in question, 2) those associated with the technological devices used, and 3) those associated with the organization of a home telemonitoring program. The highly encouraging results observed at all levels, together with demographic changes, the prevalence of chronic diseases, and the anticipated shortage of nurses in Québec warrant a gradual implementation of home telemonitoring for all healthcare services provided to the chronically ill. However, the success of such projects depends on adopting a holistic view and proactively managing the various issues and risks involved, since the technological devices provided to the patients cannot, alone, guarantee that the desired effects will be achieved. Only by meeting all conditions listed in the report can the likelihood of observing these positive effects be significantly increased.

Authors' methods: Review

Project Status: Completed

URL for project: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/revue-systematique-de-la-telesurveillance-a-domicile-dans-le-contexte-du-diabete-des-maladies-pulmonaires-et-des-maladies-cardiovasculaires.html

Year Published: 2009

URL for published report: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/revue-systematique-de-la-telesurveillance-a-domicile-dans-le-contexte-du-diabete-des-maladies-pulmonaires-et-des-maladies-cardiovasculaires.html

English language abstract: An English language summary is available

Publication Type: Other

Country: Canada

Province: Quebec

Organisation Name: Agence d'évaluation des technologies et des modes d'intervention en santé

Contact Address: 2021, avenue Union, Bureau 10.083,Montreal, Quebec H3A S29, Canada.Tel: +1 514 873 2563; Fax: +1 514 873 1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: Agence d'Evaluation des Technologies et des Modes d'Intervention en Sante (AETMIS)