We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editor's Correspondence |

Telemonitoring in Older Adults: Does One Size Fit All?

Claudio Pedone, MD, MPH; Raffaele Antonelli Incalzi, MD
Arch Intern Med. 2012;172(20):1611. doi:10.1001/archinternmed.2012.4415.
Text Size: A A A
Published online


The study by Takahashi et al1 provides useful information about the effectiveness of telemedicine. We believe that their negative results, although in line with others reported in the literature, should nonetheless be interpreted while taking into account some issues, the most evident being that the much higher mortality in the intervention group casts doubts on the real comparability of the study arms.

Furthermore, the population studied was heterogeneous with respect to the main disease. The experience with comprehensive geriatric assessment, however, clearly demonstrates that elderly and frail patients benefit from a strategy of care tailored to individual needs.2 There is no reason for thinking that such a conclusion does not apply to telemonitoring. In addition, the efficacy of telemonitoring may change according to the main disease: despite some negative trials, a recent Cochrane review indicates that in patients with congestive heart failure, telemonitoring is effective in reducing the risk of all-cause mortality and congestive heart failure–related hospitalizations.3 The lack of focus on a specific disease may also reduce the capacity of the telemonitoring team of detecting changes in health status. For example, symptoms of chronic obstructive pulmonary disease exacerbation may be aspecific4 and may be missed by study personnel not specifically trained for (tele)assisting people with this disease.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

1 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Falls, Older Adults

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Original Article: Does This Older Adult With Lower Extremity Pain Have the Clinical Syndrome of Lumbar Spinal Stenosis?