Summary
Objective: This paper analyzes evidence of the impact of patients’ adherence to pharmacological
and non-pharmacological recommendations on the treatment costs of heart failure (HF)
patients.
Methods: A systematic review was performed based on the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA) statement. Papers were searched using various combinations
of the following keywords: ‘telemedicine’, ‘telemonitoring’, ‘telehealth’, ‘eHealth’,
‘remote monitoring’, ‘adherence’, ‘compliance’, ‘cost-effectiveness’, ‘cost-benefit’,
‘heart failure’, ‘healthcare costs’, ‘hospitalization’, and ‘drug costs’. We included
only papers written in English or German, published between 1998 and 2014, and having
one of our search terms in the title.
Results: Initially, 73 papers were selected. After a detailed review, these were narrowed
done to 9 that reported an association between adherence and/or compliance and costs.
However, none established a quantitative relationship between adherence and total
healthcare costs.
Conclusion: A model-based cost-effectiveness analysis that appropriately considers adherence
has not been carried out so far, but is needed to fully understand the potential economic
benefits of telehealth.
Citation: Hameed AS, Sauermann S, Schreier G. The impact of adherence on costs and effectiveness
of telemedical patient management in heart failure: A systematic review. Appl Clin
Inf 2014; 5: 612–620
http://dx.doi.org/10.4338/ACI-2014-04-RA-0037
Keywords
Telemedicine - mHealth - therapy adherence/compliance - cost-effectiveness - heart
failure