Nine studies were included (n=858 patients). Sample size ranged from 18 to 191. Four studies (one RCT, one pre/post study, one quasi-experimental study and one prospective study) compared home telemonitoring to usual care. Of these studies, one was rated A, one rated B, one C and one D.
Five RCTs compared telephone support to usual care. Of these studies, two were rated A, two B and one D. The duration of follow-up ranged from three to nine months.
Home telemonitoring: Compared to usual care, home telemonitoring was associated with a lower number of hospital admissions (one RCT and two observational studies), a lower mean number of emergency department and scheduled visits (one pre/post study) and a lower mean number of home care visits per patient (one observational study).
Home telemonitoring was associated with mixed effects on bed days of care (two observational studies reported reductions and one reported an increase) and an increase in the mean number of office visits per patient (one observational study).
Telephone support: Compared to usual care, telephone support was associated with a lower number of patients hospitalised or hospitalised at least once (two RCTs), a lower number of patients who visited emergency departments (one RCT), a lower mean number of hospitalisations per patient (five statistically heterogeneous RCTs), a lower mean number of emergency department visits per patient (four statistically heterogeneous RCTs), a lower mean number of office visits (one RCT), a lower mean number of primary care visits per patient (one RCT), a slightly lower mean number of specialist visits per patient (one RCT) and a lower mean number of office visits (one RCT). Telephone support was associated with a non-significantly increased risk of mortality (RR 1.21, 95% CI 0.84 to 1.75; three RCTs, no significant heterogeneity) and mixed effects on bed days of care (two RCTs reported reductions and one RCT reported an increase).
Quality of life (home telemonitoring or telephone support): Two of four studies reported no difference between groups and two studies reported that home telehealth was associated with improved quality of life and patient satisfaction.