JMIR Publications

ABSTRACT

Background:

The economic burden of heart failure with reduced ejection fraction (HFrEF) is driven by frequent hospitalisations. Remote monitoring (RM) aims to prevent admissions by facilitating early intervention, but the impact of non-invasive, smartphone-based RM of vital signs on secondary healthcare usage and costs in the months after a new diagnosis of HFrEF is unknown.

Objective:

To conduct a secondary care health-usage and health economic evaluation for patients with HFrEF using smartphone-based non-invasive RM, and compare with matched controls receiving usual care without RM.

Methods:

A retrospective study of two cohorts of newly-diagnosed HFrEF patients, matched 1:1 for demographics, socio-economic status, comorbidities and HFrEF severity: (i)‘RM group’: patients using the RM platform >3 months and (ii)‘control group’: patients referred before RM was available. Emergency department (ED) attendances, hospital admissions, outpatient usage, costs and medical HFrEF therapy prescription were extracted from the Discover dataset for a 3-month period post-diagnosis, and analysed using Kaplan-Meier event analysis and Cox’s proportional hazards modelling.

Results:

146 patients (mean age 63 years; 23% female) were included (73 in each group). RM was associated with fewer ED attendances (HR=0.43, p=0.02) and unplanned admissions (HR=0.26, p=0.02), with no difference in outpatient usage (HR 1.40, p=0.18). Secondary healthcare costs were significantly lower in the RM group, despite the additional cost of RM itself (p=0.04).

Conclusions:

Smartphone-based RM of vital signs is feasible for HFrEF and is associated with reduced hospital attendance and costs, without increasing outpatient demand. This type of RM could be adjunctive to standard care to reduce admissions, enabling other resources to help patients unable to use RM. Clinical Trial: N/A