Effectiveness of Nurse-Led Telemonitoring Versus Usual Care on Readmission and Mortality Rates in Patients With...

Chronic heart failure (HF) is associated with frequent rehospitalization. Nurse-led telemonitoring uses remote capture of weight, blood pressure, heart rate, and symptoms, with nurse review and escalation. We evaluated whether nurse-led telemonitoring improves outcomes versus usual care.

In this study, we aimed to assess whether nurse-led telemonitoring, compared with usual care, improves clinical outcomes in adults with chronic heart failure, particularly hospital readmissions and mortality.

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020, we searched PubMed, Embase, CINAHL, and Cochrane Library from January 1, 2015, to May 31, 2025. Randomized trials and observational cohorts comparing nurse-led telemonitoring with usual care in adults with HF were eligible. Two reviewers independently screened records, extracted data using a piloted form, and assessed risk of bias (Cochrane RoB 2.0; RoBINS-I). Primary outcomes were all-cause and heart-failure readmissions and mortality. Random-effects meta-analyses were conducted; heterogeneity and small-study effects were examined.

Eighteen studies met criteria (11 randomized trials; 7 cohorts; about 20,000 participants). Interventions typically combined daily remote measurements with proactive nurse follow-up. Compared with usual care, telemonitoring reduced all-cause readmissions and heart-failure readmissions. Pooled mortality in randomized trials showed a nonsignificant trend favoring telemonitoring, while large real-world cohorts showed lower 1-year mortality among telemonitored patients. Risk of bias was low to moderate, with performance bias common due to the nature of the intervention.

Nurse-led telemonitoring is associated with fewer hospital readmissions and signals toward improved survival. Programs that include active nurse engagement and timely response to alerts appear most effective. Further adequately powered trials with longer follow-up and standardized intervention components are needed.