JMIR Publications

ABSTRACT

Background:

Heart failure (HF) is the primary cause of hospitalization among patients aged 65 and above in Canada. Care for patients with HF requires regular clinical follow-up to prevent readmissions and facilitate medical therapy optimization. Remote patient monitoring (RPM) and digital therapeutics (DTx) solutions have been developed to improve the management of HF patients. The Continuum project is a collaborative effort between a healthcare center, a software start-up, and an industrial partner to develop and test an intervention that combines an efficient RPM system with a DTx solution for HF.

Objective:

To develop and test an intervention that combines an efficient RPM system with a DTx solution for HF.

Methods:

A 3-month pre-post pilot study was conducted from October 2020 to June 2021. The intervention group (RPM+) consisted of HF patients who had a smartphone or tablet and entered their vital signs, weight, and HF symptoms into the app. Patients who did not possess a mobile device or did not know how to use the app were enrolled in the control group (RPM-).

Results:

A total of 52 patients were enrolled in this study (32 RPM+ and 20 RPM-). More patients in the RPM- group experienced at least one all-cause hospitalization compared to the RPM+ group (35% versus 6%, p=0.008), as well as HF hospitalization (25% versus 6%, p=0.054). Patients treated with the DTx solution were more likely to have their HF therapy optimized. Quality of life was higher for the patients who were most compliant with the intervention (GLM interaction p=0.01, moderate to large clinical impact).

Conclusions:

This pilot study demonstrated the feasibility of RPM and DTx solutions for managing HF patients. Preliminary results suggest promising impacts on quality of life, hospitalizations, and medication optimization. Clinical Trial: Pilot study #21.403 Active randomized controlled trial following pilot study: NCT05377190