Effect of a digital health intervention on outpatients with heart failure: a randomized, controlled trial

Aims Heart failure (HF) is associated with high mortality and reduced quality of life (QoL). Interventions encouraging a healthy lifestyle and self-care can reduce morbidity and HF-related hospitalizations. We conducted a randomized controlled trial (RCT) to assess the impact of a digital health programme on QoL and clinical outcomes of patients. The programme included remote patient monitoring (RPM), self-care, HF education, and empowered positive lifestyle changes. Methods and results Patients (n = 175) received standard-of-care (SoC) at a HF outpatient clinic (control, n = 89) or SoC plus a digital health programme (intervention, n = 86) for 6 months, followed by a 6-month maintenance period. Compliance with RPM was 93% at 6 months. No significant between-group difference was found in the primary endpoint (health-related QoL), except in an exploratory subgroup of New York Heart Association class III patients, where the intervention group had a significantly smaller QoL decline (P = 0.023). For secondary endpoints, the intervention group had significantly greater improvements in self-care at 6 months (P < 0.001) and 12 months (P = 0.003), and in disease-specific knowledge at 12 months (P = 0.001). Several exploratory endpoints favoured the intervention, with significant improvements in triglycerides (P = 0.012), HbA1c (P = 0.014), and fasting glucose (P = 0.010). The TG/HDL cholesterol ratio and TG/glucose index improved significantly at both 6 and 12 months in between-group comparisons. Conclusion Although the digital programme did not improve health-related QoL, it led to benefits in other important outcomes such as self-care, disease-specific knowledge, and several key metabolic parameters.