Why the study?
Heart failure hospitalizations continue to increase due to suboptimal outpatient management, and remote patient monitoring using noninvasive home-based sensors has failed to demonstrate clinical efficacy.
Does a noninvasive remote patient monitoring platform reduce heart failure hospitalizations and improve medication titration in patients with heart failure with reduced ejection fraction?
Does a noninvasive remote patient monitoring platform reduce heart failure hospitalizations and improve medication titration in patients with heart failure with reduced ejection fraction?
Answers are grounded in this paper and cite their sources.
This protocol outlines a prospective study to evaluate whether a novel noninvasive remote patient monitoring platform, including a ballistocardiograph, can improve guideline-directed medical therapy titration and reduce hospitalizations in patients with heart failure with reduced ejection fraction.
BACKGROUND: Heart failure remains a leading cause of mortality and a major driver of health care utilization. Despite numerous medical advances in heart failure, associated hospitalizations continue to increase, owing largely to suboptimal outpatient management. Remote patient monitoring (RPM) aims to further address this current need in heart failure care by providing data to clinical teams to act pre-emptively to address clinical decompensation. However, to date, RPM approaches using noninvasive home-based patient sensors have failed to demonstrate clinical efficacy. OBJECTIVE: The Novel Data Collection and Analytics Tools for Remote Patient Monitoring in Heart Failure (Nov-RPM-HF) Trial aims to address current noninvasive RPM limitations. Nov-RPM-HF will evaluate a clinician co-designed RPM platform using emerging data collection and presentation tools for heart failure management. These tools include a ballistocardiograph to monitor nocturnal patient biometrics, clinical alerts for abnormal biometrics, and longitudinal data presentation for clinician review. METHODS: Nov-RPM-HF is a 100-patient single-center prospective trial, evaluating patients over 6 months. The outcomes will include patient adherence to data collection, patient/clinician-perceived utility of the RPM platform, medication changes including the titration of guideline-directed medical therapy to target doses, heart failure symptoms/performance status, and unplanned heart failure hospitalizations or emergency department visits. RESULTS: This prospective trial began enrollment in March 2020 and anticipates enrollment completion by June 2022, with trial completion by December 2022. CONCLUSIONS: This trial protocol aims to provide a systematic framework for the evaluation of heart failure RPM strategies, which are currently heavily used but seldom robustly studied. The trial results will help to inform the role of noninvasive RPM as a viable clinical management strategy in heart failure care. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/32873.
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Bhatia et al. (2021) studied Heart failure with reduced ejection fraction (n=100). Nov-RPM-HF platform vs. Matched historical controls was evaluated on Heart failure hospitalizations.
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