Abstract 18895: Utility of Remote Monitoring Using a Mobile Phone in Patients with Heart Failure: the REMOTE-HF-1 Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Marcus Stahlberg ◽  
Satish C Govind ◽  
Nicole M Orr ◽  
Aasha S Gopal ◽  
Justine S Lachmann ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Mobile Phone ◽  
Monitoring System ◽  
Primary Endpoint ◽  
Remote Monitoring ◽  
Nyha Class ◽  
Drop Out ◽  
Remote Monitoring System ◽  
Custom Made

Objective: To investigate the clinical feasibility (technical feasibility and patient-/clinician adherence) of remote telemonitoring, using a mobile phone, in an international and diverse HF population. Methods: HF patients from five centers in the USA, India and Sweden were equipped with a blood pressure apparatus, digital weight scale and a mobile phone device with custom made software for remote telemonitoring (Vitalbeat®). Patients were asked to record and transmit daily information on body weight, blood pressure and pulse rate as well as symptoms and adherence to medical therapy for 90 days. The primary endpoint, for assessment of general feasibility was defined as % of days with a combination of successful data transmission from patients and data read by clinicians. Acceptable clinical feasibility was a priori set as ≥ 66% of days meeting the primary endpoint. A survey was used to assess patients’ opinions about the remote monitoring system. Data was analyzed according to Intention to treat. Results: 46 HF patients were included (India=20, USA=13, Sweden=13; 59±16yrs; 84% male; NYHA-class 2.4±0.8) and followed for a total of 4410 days. The primary endpoint occurred in 3178 days (77%) and 34/46 patients (74%) exceeded the cut-off ≥ 66% of days meeting endpoint criteria. In the majority of patients (n=28; 61 %) the primary endpoint was met ≥ 90% of the days, and in 6 patients (13%) 66-89% of the days.Twelve patients (26%) opted to drop out of the study prematurely or were hospitalized for HF related causes. Compared to patients with acceptable clinical feasibility (≥ 66%), patients with less than acceptable feasibility (< 66%) were older (72±12 vs. 56±15 yrs, p=0.003) and more likely to be followed at a center in USA or Sweden (p=0.02 vs. Indian centers). The monitoring system was described as user friendly by 91 % of patients. Conclusion: This study shows that remote telemonitoring using a mobile phone is clinically feasible in an international and diverse heart failure population. However, monitoring was less feasible in elderly patients and depended on the geographic location. Further studies are warranted to assess whether clinical feasibility can improve with improved software/hardware design and/or patient selection.

scholarly journals Integration and Adoption Analysis of Digital Health Monitoring Devices: Reflections of a Pilot Project (Preprint)

2018 ◽  
Author(s):  
Christopher Park ◽  
Emmamuzo Otobo ◽  
Jason Rogers ◽  
Farah Fasihuddin ◽  
Shashank Garg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Monitoring System ◽  
Remote Monitoring ◽  
Hospital Readmissions ◽  
Smart Devices ◽  
Remote Monitoring System ◽  
Factors Associated ◽  
Digital Medicine ◽  
Monitoring Devices

BACKGROUND Congestive heart failure (CHF) is a disease that affects about 6.5 million people in the United States with a mortality rate of around 30%. With the incidence rate projected to rise by 46% to exceed 8 million cases by 2030, projections estimate that total CHF costs will increase about to nearly $70 billion. Recently, the advent of remote monitoring technology has significantly broadened the scope of the physician’s reach in chronic disease management. Using remotely monitored health data, providers may be able to better manage and predict their patients’ outcomes, leading to reduced incidence and hospital admission costs. OBJECTIVE This project aimed to demonstrate the feasibility of a digital medicine engagement platform for CHF patients, including identifying factors associated with increased risk of readmission and assessing usage patterns of remote monitoring devices. METHODS The project included 60 patients admitted to Mount Sinai Hospital for CHF. A digital medicine platform by Rx.Health, called RxUniverse, was used to prescribe HealthPROMISE and iHealth mobile apps. Patients updated and recorded their CHF-related symptoms and quality of life measures daily on HealthPROMISE. Vital sign data, including blood pressure and weight, were collected through an ambulatory remote monitoring system that integrated the iHealth app and complementary consumer grade Bluetooth-connected smart devices (blood pressure cuff and digital scale). Physicians were notified of abnormal patient blood pressure and weight change readings and further action was left to the physician’s discretion. We used statistical analyses to determine risk factors associated with 30-day all-cause readmission. RESULTS Overall, there were six 30-day hospital readmissions (10%), compared to the national readmission rates of around 25%. Single marital status (P<.1) and history of percutaneous coronary intervention (P<.1) were associated with readmission. Readmitted patients were also less likely to have been previously prescribed angiotensin converting enzyme inhibitors or angiotensin II receptor blockers (P<.05). Notably, readmitted patients utilized the blood pressure and weight monitors less than non-readmitted patients, and patients aged less than 70 used the monitors more frequently on average than those over 70, though these trends did not reach statistical significance. The percentage of patients using the monitors at least once dropped steadily from 83% in the first week after discharge to 46% in the fourth week. Additionally, 88% of patients used the monitor at least 4 times and 62% at least 10 times, with some patients using the monitors multiple times per day. CONCLUSIONS Given the increasing burden of CHF, there is a need for an effective and sustainable remote monitoring system for CHF patients following hospital discharge. We identified clinical and social factors as well as remote monitor usage trends that identify targetable patient populations that could benefit most from integration of daily remote monitoring. In addition, we demonstrated that interventions driven by real-time vitals data may greatly aid in reducing hospital readmissions and costs while improving patient outcomes. Future studies should seek to implement remote monitoring and confirm usage trends as well as risk factors in a large-scale population.

Safety Evaluation of an Automated Remote Monitoring System for Heart Failure in an Urban, Indigent Population

2017 ◽  
Vol 20 (6) ◽  
pp. 449-457 ◽  
Author(s):  
Sandra Gross-Schulman ◽  
Laura Myerchin Sklaroff ◽  
Crystal Coyazo Hertz ◽  
Jeffrey J. Guterman
Keyword(s):  
Heart Failure ◽  
Monitoring System ◽  
Remote Monitoring ◽  
Safety Evaluation ◽  
Remote Monitoring System ◽  
Indigent Population

Expectations for the Remote Monitoring System in Heart Failure Patients with CRT

2013 ◽  
Vol 19 (10) ◽  
pp. S118
Author(s):  
Makoto Suzuki ◽  
Yuya Matsue ◽  
Rena Nakamura ◽  
Maki Ono ◽  
Ryota Iwatsuka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Monitoring System ◽  
Remote Monitoring ◽  
Remote Monitoring System ◽  
Heart Failure Patients

scholarly journals First experience with a ready-to-use solution for remote monitoring of patients suffering from heart failure

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
H Lemieux ◽  
F Picard ◽  
F Barritault ◽  
J Labarre ◽  
S Lafitte ◽  
...  
Keyword(s):  
Heart Failure ◽  
Monitoring System ◽  
Remote Monitoring ◽  
Web Application ◽  
Patient Management ◽  
Remote Monitoring System ◽  
Funding Sources ◽  
Current Period ◽  
Potential Benefits

Abstract Funding Acknowledgements Type of funding sources: None. Background Heart failure (HF) is associated with a high mortality rate and recurrent hospitalizations. Purpose To present the first data of the patients using Satelia® Cardio solution Method Satelia® Cardio is a HF patient management solution with a remote monitoring system and a therapeutic guidance by a dedicated-nurse phone platform, supported by the ETAPES Program. The system is accessible from any device and requiring no installation. After the inclusion, the patient is contacted by the nurse, he then receives an SMS alerts following cardiologist prescription (on regular basis), with a link leading to a web page on which he will answer 7 questions and enter his current body weight. Satelia® Cardio algorithm is based on these data inputs, their variability, and the weight. In case of worsening of symptoms, the cardiologist will be notified. Since Covid-19 lockdown, more than 1400 patients have been monitored with the solution. Results 165 centers (306 cardiologists) are using Satelia® Cardio with 3540 HF patients monitored in the last 29 months. The patients with a mean age of 72 years (19-100) are predominantly males (67%), and mostly NYHA II/III (69%/31%) with a mean LVEF of 40%. The adherence to the system is very good (91%) with 78% of patients still monitored (n = 2787). The main reasons for stopping are related to the occurrence of death (205/753) or patient/HCP decision (392/753), or other reasons (156/753). Over the period of analysis, the HF patients answered to 163 700 questionnaires, generating 8210 alerts transmitted to the referent cardiologists. Conclusion Patient management solution with a remote monitoring system is key to improving the follow-up of HF patients. The solution Satelia® Cardio is an easy way to use a web application to monitor HF patients, especially on the current period of Covid-19 with a low rate of premature discontinuation. A further step will be to initiate studies to assess the potential benefits for both patients and HCPs  of such remote monitoring solution in HF.

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