Managing chronic illnesses with remote patient monitoring in primary health care
Research report, Systematic Review
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Remote patient monitoring (RPM) allows for the real-time trans-mission of health data, evaluation of this data, and appropriate follow-up. This allows providers to monitor the health status of chronically ill patients and quickly adjust treatment regimes, without requiring that patients continually visit providers’ of-fices. We summarized systematic reviews of a specific type of RPM that the Norwegian Directorate of Health is most interested in: RPM that is occurring in primary health services, in which provider feedback is included, and not including technologies based on in-ternet, mobile, or tablet applications. We included 11 randomized controlled trials of patients with di-abetes and/or hypertension, from four systematic reviews. Pa-tients were on average in their 50s, 60s, or 70s, and roughly one to two of every 20 patients had at least one additional multi-mor-bidity. Based on summaries of each outcome and our assessment of the certainty of the evidence, we have drawn the following conclu-sions: RPM probably makes little to no difference on HbA1c in dia-betic patients (types I and II) and on systolic blood pressure in hypertensive patients. RPM probably has a small negative effect on the physical component of health-related quality of life. RPM may make little to no difference to diastolic blood pressure, cholesterol, number of patients needing hospitalizations or emergency stays, and the mental health component of health-related quality of life. The specific type of RPM we examined in this review does not appear commonly implemented among people with chronic conditions other than diabetes or hypertension. Evidence of its clinical and health care utilization effectiveness is weak.