Analytical approach:
The economic evaluation was carried out alongside a trial with a time horizon of six months. The authors stated that the perspective was that of the UK National Health Service (NHS).
Effectiveness data:
The clinical data came from the multi-centre, prospective, randomised controlled trial (RCT), in which randomisation took place at the patient level within each hospital. Patients in the New York Heart Association classes II to IV at the time of discharge were recruited from three acute hospitals and randomised to telemonitoring (n=91) or usual care (n=91). The length of follow-up was six months, with measurements carried out at baseline and three and six months. A total of nine patients were lost to follow-up in the telemonitoring group and seven in the usual care group. The main outcome was the number and duration of all non-elective hospitalisations. To adjust for the impact of death, this was expressed as the number of days that the patient was alive and out of hospital. Secondary outcomes were heart-failure related admissions, health-related quality of life, and anxiety and depression, which were measured using the Hospital Anxiety and Depression Score.
Monetary benefit and utility valuations:
The utility values were estimated from two multi-attribute self-administered postal questionnaires: the disease-specific Minnesota Living with Heart Failure questionnaire and the generic European Quality of life (EQ-5D) questionnaire.
Measure of benefit:
Health-related quality of life was the benefit measure.
Cost data:
The analysis considered the direct costs of telemonitoring equipment, hospital readmission, drugs, primary care visits, secondary care visits, and hospital transport. Information on the resources used was collected prospectively from the trial using hospital records and the health diaries recorded by the patients. The unit costs were from published national databases. All costs were expressed in UK pounds sterling (£).
Analysis of uncertainty:
No sensitivity analyses were performed.