Abstract 4367189: Clinical Efficacy of Telemedicine vs Standard Outpatient Management for Heart Failure: A Systematic Review and Meta-Analysis

Abstract

Background: Telemedicine (TM) modalities—home tele-monitoring and structured telephone support—are proposed to improve outcomes in heart failure (HF), yet pooled effects remain inconsistent. Methods: PubMed, Embase, Cochrane, and Web of Science were searched to 1 June 2025 for randomised controlled trials (RCTs) or prospective cohorts comparing TM with usual outpatient HF care. Primary endpoints were all-cause mortality and HF-related readmission; quality of life (QoL) was secondary. Risk ratios (RRs) were pooled with a random-effects model (I2 for heterogeneity). Risk of bias was assessed with Cochrane RoB 2 and Newcastle–Ottawa tools. Protocol: PROSPERO. Results: Twenty-eight studies (24 RCTs, 4 cohorts) enrolling 11 334 patients (mean age 69 y; 37 % women) met criteria. TM reduced mortality (pooled RR 0.81, 95 % CI 0.72–0.91; I2 18 %). Benefit was greatest in tele-monitoring trials (RR 0.66, 0.54–0.81; 2 710 patients), whereas telephone support showed a non-significant trend (RR 0.88, 0.76–1.01).TM lowered HF readmissions by 22 % (RR 0.78, 0.69–0.88; I2 25 %) and had no effect on all-cause hospitalisations (RR 0.96, 0.88–1.04). QoL improved in six of eight studies reporting the Minnesota Living with HF Questionnaire (mean difference –3.4 points). Funnel-plot symmetry and Egger’s test (p = 0.28) suggested no publication bias; most trials were low-to-moderate risk. Conclusions: Across >11 000 HF patients, TM—especially home tele-monitoring—significantly reduces mortality and HF-specific readmissions and modestly enhances QoL compared with standard outpatient management. These contemporary data support routine integration of TM into HF care pathways and its inclusion in future guideline recommendations.