Is telemedicine effective in the management of cardiovascular disease?

Telemedicine has been increasingly incorporated into the monitoring and management of patients with chronic health conditions. Mainly during and after the covid-19 pandemic, this resource has been used both for monitoring and for consultations. Among the most common types of chronic diseases are cardiovascular diseases – which represent the greatest cause of mortality and morbidity in the world. To help lessen this all-important impact, telemedicine can be critical. In this sense, it is essential to assess the ability of this resource to manage cardiovascular diseases and prevent their outcomes.

telemedicine

Study

In a study published in Lancet Digital Health, in August 2022, researchers performed a systematic review and meta-analysis on the effectiveness of telemedicine in the management of cardiovascular conditions. Evaluating database studies pubmed, Cochraneand scopus, published until January 2018, searched for articles that related the effects of telemedicine interventions on cardiovascular outcomes, both for people at risk (primary prevention) and for people already with established disease (secondary prevention). The primary outcome considered was mortality from causes related to cardiovascular diseases.

A total of 127,869 participants from the 72 selected studies were included. When compared to usual face-to-face care, the combination of telemonitoring and teleconsultation strategies for patients with heart failure was associated with a reduced risk of mortality from causes related to cardiovascular diseases (RR 0.83; 95% CI 0.70 – 0, 99; p = 0.036) and the risk of hospitalization for cardiovascular causes (RR 0.71; 95% CI 0.58 – 0.87; p = 0.0002). These findings were mainly present in studies with short follow-up periods (less than 12 months). There was no effect to decrease mortality and hospitalization from all causes in these groups.

For patients undergoing secondary prevention, the use of telemonitoring in conjunction with teleconsultations was shown to reduce systolic blood pressure, with a small but significant mean difference of -3.59% (95% CI -5.35 – 1 .83) p < 0.0001). It is also noteworthy that the beneficial results found are not maintained when isolated teleconsultation is used, without combination with telemonitoring.

Know more: CFM regulates rules for telemedicine and physician has autonomy to decide form of care

Considerations

Research findings suggest that there is an important place for telemedicine in the management of heart failure and likely other cardiovascular conditions. Both to support in scenarios where face-to-face care is not possible or facilitated, and to complement local services, the combination of telemonitoring with teleconsultation seems to optimize treatments and specific guidelines for patients with this type of health condition. The study demonstrated a reduction in mortality and hospitalization for cardiovascular causes associated with these telemedicine practices, as well as small gains in the management of risk factors.

Although the certainty of these benefits is less for patients with cardiovascular diseases other than heart failure, the results are promising. New studies, with longer deadlines, unselected populations and different designs are expected to better consolidate the role of telemedicine in the care of chronic patients.

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