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Results of pilot remote monitoring of heart failure patients

https://doi.org/10.15829/1728-8800-2022-3151

Abstract

Aim. To analyze the results of remote monitoring of patients with decompensated heart failure (HF) based on the assessment of quality of life (QOL), self-care ability and adherence to treatment 3 and 6 months after discharge from the hospital.

Material and methods. The first group (experimental) consisted of 70 patients who, along with the approved healthcare standard, underwent measures according to the developed model for managing HF patients, including remote monitoring. The second group (control) included 65 patients who received care according to generally accepted algorithms for managing HF patients. In the study group, there were 46% men (69,6±9,4 years) and 54% women (71,7±9,9 years). The control group also included 46% men (70,6±9,1 years) and 54% women (73,0±10,3 years). Class I HF in the first group had 4%, while in the second — 3%; class II HF in both groups occurred in 11%; class III in the first group — 43%, in the second group — 54%, class IV HF in the first group — 41%, in the second group — 32% of patients. We conducted a standard clinical examination, assessed QOL, self-care ability, and adherence to treatment.

Results. In the first group, after 3 months, compared with the baseline, the average Minnesota Satisfaction Questionnaire (MSQ) score was lower by 37 (p=0,037), while after 6 months — by 33,6 (p=0,026). After 3 months according to the MSQ, the QOL in the second group was higher by 7,9 points (p=0,0001); according to the Morisky-Green test — lower by 1,2 points (p=0,0003); according to the self-care questionnaire — higher by 4,7 points (p=0,0001) than in the first group. After 6 months, MSQ score in the second group was higher by 10,4 points (p=0,0001), according to the Morisky-Green test — lower by 1,8 points (p=0,0003); according to the self-care questionnaire  — higher by 5,6 points (p=0,0001) than in the study group.

Conclusion. The developed model for managing HF patients using remote monitoring, in comparison with the generally accepted standards, has led to an increase in QOL, adherence to treatment and self-care ability of patients.

About the Authors

N. V. Pyrikova
Altai State Medical University
Russian Federation

Barnaul



N. A. Mozgunov
City Clinical Hospital № 11
Russian Federation

Barnaul



I. V. Osipova
Altai State Medical University
Russian Federation

Barnaul



References

1. Liu L, Yin X, Chen M, et al. Geographic Variation in Heart Failure Mortality and Its Association with Hypertension, Diabetes, and Behavioral-Related Risk Factors in 1,723 Counties of the United States. Front Public Health. 2018;6:132. doi:10.3389/fpubh.2018.00132.

2. Arutyunov GP, Kolesnikova EA, Begrambekova YuL, et al. Exercise training in chronic heart failure: practical guidance of the Russian Heart Failure Society. Heart Failure Journal. 2017;18(1):41-66. (In Russ.) doi:10.18087/rhfj.2017.1.2339.

3. Correction to “Rehospitalization in a National Population of Home Health Care Patients with Heart Failure”. Health Services Research. 2017;52(5):1958-60. doi:10.1111/1475-6773.12761.

4. Russian Society of Cardiology (RSC). 2020 Clinical practice guidelines for Chronic heart failure. Russian Journal of Cardiology. 2020;25(11):4083. (In Russ.) doi:10.15829/1560-4071-2020-4083.

5. Fomin IV, Polyakov DS, Badin YuV, et al. Arterial hypertension in European Russia from 1998 to 2007: What did we achieve at the population level? Serdce: zhurnal dlya praktikuyushchih vrachej. 2016;15(5):369-78. (In Russ.) doi:10.18087/RHJ.2016.5.2240.

6. Nasonova SN, Lapteva AE, Zhirov IV, et al. Remote monitoring in patients with chronic heart failure in real clinical practice. Kardiologiia. 2021;61(8):76-86. (In Russ.) doi:10.18087/cardio.2021.8.n1683.

7. Mareev YuV, Zinchenko AO, Myasnikov RP, et al. Telemonitoring in patients with chronic heart failure. Kardiologiia. 2019;59(9S):415. (In Russ.) doi:10.18087/cardio.n530.

8. Lynga P, Persson H, Hägg-Martinell A, et al. Weight monitoring in patients with severe heart failure (WISH). A randomized controlled trial. Eur J Heart Fail. 2012;14(4):438-44. doi:10.1093/eurjhf/hfs023.

9. Boyne JJJ, Vrijhoef HJM, Crijns HJGM, et al. Tailored telemonitoring in patients with heart failure: results of a multicentre randomized controlled trial. Eur J Heart Fail. 2012;14(7):791-801. doi:10.1093/eurjhf/hfs058.

10. Ong MK, Romano PS, Edgington S, et al. Effectiveness of Remote Patient Monitoring After Discharge of Hospitalized Patients with Heart Failure: The Better Effectiveness After Transition–Heart Failure (BEATHF) Randomized Clinical Trial. JAMA Int Med. 2016;176(3):310-8. doi:10.1001/jamainternmed.2015.7712.

11. Koehler F, Winkler S, Schieber M, et al. Impact of Remote Telemedical Management on Mortality and Hospitalizations in Ambulatory Patients with Chronic Heart Failure: The Telemedical Interventional Monitoring in Heart Failure Study. Circulation. 2011;123(17):1873-80. doi:10.1161/CIRCULATIONAHA.111.018473.

12. Mizukawa M, Moriyama M, Yamamoto H, et al. Nurse-Led Collaborative Management Using Telemonitoring Improves Quality of Life and Prevention of Rehospitalization in Patients with Heart Failure: A Pilot Study. Int Heart J. 2019;60(6):1293-302. doi:10.1536/ihj.19-313.

13. Dierckx R, Inglis SC, Clark RA, et al. Telemedicine in heart failure: new insights from the Cochrane meta-analyses: Viewpoint. Eur J Heart Fail. 2017;19(3):304-6. doi:10.1002/ejhf.759.

14. Pekmezaris R, Tortez L, Williams M, et al. Home Telemonitoring In Heart Failure: A Systematic Review and Meta-Analysis. Health Aff. 2018;37(12):1983-9. doi:10.1377/hlthaff.2018.05087.

15. Hanlon P, Daines L, Campbell C, et al. Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer. J Med Internet Res. 2017;19(5):e172. doi:10.2196/jmir.6688.

16. Koehler F, Koehler K, Deckwart O, et al. Efficacy of telemedical interventional management in patients with heart failure (TIMHF2): a randomised, controlled, parallel-group, unmasked trial. Lancet. 2018;392(10152):1047-57. doi:10.1016/S01406736(18)31880-4.

17. Order of the Ministry of Health of the Russian Federation dated December 24, 2012 No. 1554n “On approval of the standard for specialized medical care for heart failure”. (In Russ.) https://base.garant.ru/70347188/. (02.02.2022).

18. Rector TS, Kubo SH, Cohn JN. Patient’s self-assessment of their congestive heart failure. Part 2: Content, reliability and validity of a new measure. The Minnesota Living with Heart Failure Questionnaire. Heart Fail. 1987;3:198-209.

19. Morisky DE, Ang A, Krousel-Wood M, et al. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich). 2008;10(5):348-54.

20. Boytsov SA, Ageev FT, Blankova ZN, et al. Guidelines for nurses in the office of patients with chronic heart failure. М.: FGBU “Nacional’nyj medicinskij issledovatel’skij centr kardiologii” Ministerstva zdravoohraneniya Rossijskoj Federacii i OOO “Obshchestvo specialistov po serdechnoj nedostatochnosti”, 2020. р. 36. (In Russ.)

21. Van Spall HGC, Lee SF, Xie F, et al. Effect of Patient-Centered Transitional Care Services on Clinical Outcomes in Patients Hospitalized for Heart Failure. The PACT-HF Randomized Clinical Trial. JAMA. 2019;321(8):753-61. doi:10.1001/jama.2019.0710.

22. Van Spall HGC, Rahman T, Mytton O, et al. Comparative effectiveness of transitional care services in patients discharged from the hospital with heart failure: a systematic review and network meta-analysis. Eur J Heart Fail. 2017;19(11):1427-43. doi:10.1002/ejhf.765.

23. Masoudi FA. A Transitional-Care Model to Reduce Readmissions After Heart Failure? NEJM Journal Watch. 2019;321. doi:10.1056/NEJM-JW.NA48626.

24. De Vecchis R, Paccone A, Di Maio M. Effects of a Restricted Water Intake on Various Clinical and Laboratory Outcomes in Patients with Heart Failure: A Meta-Analysis of Randomized Controlled Trials. Minerva Cardioangiol. 2020. Online ahead of print. doi:10.23736/S0026-4725.20.05072-0.

25. Efremova EV, Mevzorov MV, Sabitov IA. Commitment to treatment of patients with chronic heart failure in the conditions of a komorbidnost. Clinical medicine. 2015;10:20-4. (In Russ.)

26. Huang J, Fang JB, Zhao YH. The Relationship Between Quality of Life and Psychological and Behavioral Factors in Patients with Heart Failure Following Cardiac Resynchronization Therapy. Hu Li Za Zhi. 2018;65(3):58-70. doi:10.6224/JN.201806_65(3).09.

27. Grebennikova AA, Stolyarov AYu, Lopatin YuM. Application of a remote monitoring platform based on a mobile application to increase adherence to self-care in patients with chronic heart failure. Kardiologiia. 2017;57(S4):11-8. (In Russ.) doi:10.18087/cardio.2413.


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For citations:


Pyrikova N.V., Mozgunov N.A., Osipova I.V. Results of pilot remote monitoring of heart failure patients. Cardiovascular Therapy and Prevention. 2022;21(6):3151. (In Russ.) https://doi.org/10.15829/1728-8800-2022-3151

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ISSN 1728-8800 (Print)
ISSN 2619-0125 (Online)