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First published February 28, 2007 as JAMIA PrePrint; doi:10.1197/jamia.M2270
Journal of the American Medical Informatics Association 2007;14(3):269-277
© 2007 American Medical Informatics Association


A more recent version of this article appeared on May 1, 2007
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Submitted on September 8, 2006
Accepted on January 16, 2007

Systemic Review of Home Telemonitoring for Chronic Diseases: The Evidence Base

Guy Pare PhD1*, Mirou Jaana PhD1, and Claude Sicotte PhD2

Affiliation of the authors: 1 Canada Research Chair in Information Technology in Health Care, HEC Montréal, Montreal (Quebec), Canada ; 2 Health Administration Department, University of Montreal, Montreal (Quebec), Canada

* To whom correspondence should be addressed.

Home telemonitoring represents a patient management approach combining various information technologies for monitoring patients at distance. This study presents a systematic review of the nature and magnitude of outcomes associated with telemonitoring of four types of chronic illnesses: pulmonary conditions, diabetes, hypertension, and cardiovascular diseases. A comprehensive literature search was conducted on Medline and Cochrane Library to identify relevant articles published between 1990 and 2006. A total of 65 empirical studies were obtained (18 = pulmonary conditions; 17 = diabetes; 16 = cardiac diseases; 14 = hypertension) mostly conducted in the United States and Europe. The magnitude and significance of the telemonitoring effects on patients' conditions (e.g., early detection of symptoms, decrease in blood pressure, adequate medication, reduced mortality) still remain inconclusive for all four chronic illnesses. However, our results suggest that regardless of their nationality, socio-economic status, or age, patients comply with telemonitoring programs and the use of technologies. Importantly, the telemonitoring effects on clinical effectiveness outcomes (e.g., decrease in the emergency visits, hospital admissions, average hospital length of stay) are more consistent in pulmonary and cardiac studies than diabetes and hypertension. Lastly, economic viability of telemonitoring was observed in very few studies and, in most cases, no in-depth cost-minimization analyses were performed. Home telemonitoring of chronic diseases appears as a promising patient management approach that produces accurate and reliable data, empowers patients, influences their attitudes and behaviors, and potentially improves their medical conditions. Future studies need to build evidence related to its clinical effects, cost effectiveness, impacts on services utilization, and acceptance by health care providers.




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