Twenty RCTs (n=6,258, range 34 to 1,518) and 12 cohort studies (n=2,354, range 24 to 502) were included in the review. Two RCTs had three arms that compared usual care, telephone monitoring and technology-assisted monitoring. Ten out of 20 RCTs and 10 of 12 cohort studies had a quality score less than 8. Median follow-up duration was six months in the RCTs and 12 months in the cohort studies.
RCTs: Remote patient monitoring was associated with a significantly lower number of deaths (RR 0.83, 95% CI 0.73 to 0.95; 19 arms), a lower number of hospitalisations for any cause (RR 0.93, 95% CI 0.87 to 0.99; 11 arms) and a lower number of hospitalisations due to heart failure (RR 0.71, 95% CI 0.64 to 0.80; 13 arms) than usual care. Little heterogeneity was detected (I2<20%). Remote patient monitoring was associated with significantly lower numbers than usual care for combined end point of death and first hospitalisation (RR 0.86, 95% CI 0.79 to 0.94; six arms). Some heterogeneity was present (I2 = 28%). Sensitivity analyses showed similar results.
Cohort studies: Remote patient monitoring was associated with a significantly lower number of deaths (RR 0.53, 95% CI 0.29 to 0.96; six studies) and hospitalisations (RR 0.52, 95% CI 0.28 to 0.96; three studies) compared with usual care. High levels of heterogeneity were present (I2=59% for number of deaths and 82% for hospitalisations).
Funnel plots were presented in the online version of the report, but were not interpreted in this paper.