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Title: | A Novel Intelligent Two-Way Communication System for Remote Heart Failure Medication Uptitration (the CardioCoach Study): Randomized Controlled Feasibility Trial | Authors: | SMEETS, Christophe STORMS, Valerie VANDERVOORT, Pieter DREESEN, Pauline VRANKEN, Julie Houbrechts, Marita Goris, Hanne GRIETEN, Lars DENDALE, Paul |
Issue Date: | 2018 | Source: | JMIR Cardio, 2 (1) (Art N° e8) | Abstract: | Background: European Society of Cardiology guidelines for the treatment of heart failure (HF) prescribe uptitration of
angiotensin-converting enzyme inhibitors (ACE-I) and β-blockers to the maximum-tolerated, evidence-based dose. Although HF
prognosis can drastically improve when correctly implementing these guidelines, studies have shown that they are insufficiently
implemented in clinical practice.
Objective: The aim of this study was to verify whether supplementing the usual care with the CardioCoach follow-up tool is
feasible and safe, and whether the tool is more efficient in implementing the guideline recommendations for β-blocker and ACE-I.
Methods: A total of 25 HF patients were randomly assigned to either the usual care control group (n=10) or CardioCoach
intervention group (n=15), and observed for 6 months. The CardioCoach follow-up tool is a two-way communication platform
with decision support algorithms for semiautomatic remote medication uptitration. Remote monitoring sensors automatically
transmit patient’s blood pressure, heart rate, and weight on a daily basis.
Results: Patients’ satisfaction and adherence for medication intake (10,018/10,825, 92.55%) and vital sign measurements
(4504/4758, 94.66%) were excellent. However, the number of technical issues that arose was large, with 831 phone contacts
(median 41, IQR 32-65) in total. The semiautomatic remote uptitration was safe, as there were no adverse events and no false
positive uptitration proposals. Although no significant differences were found between both groups, a higher number of patients
were on guideline-recommended medication dose in both groups compared with previous reports.
Conclusions: The CardioCoach follow-up tool for remote uptitration is feasible and safe and was found to be efficient in
facilitating information exchange between care providers, with high patient satisfaction and adherence.
Trial Registration: ClinicalTrials.gov NCT03294811; https://clinicaltrials.gov/ct2/show/NCT03294811 (Archived by WebCite
at http://www.webcitation.org/6xLiWVsgM) Background: European Society of Cardiology guidelines for the treatment of heart failure (HF) prescribe uptitration of angiotensin-converting enzyme inhibitors (ACE-I) and β-blockers to the maximum-tolerated, evidence-based dose. Although HF prognosis can drastically improve when correctly implementing these guidelines, studies have shown that they are insufficiently implemented in clinical practice. Objective: The aim of this study was to verify whether supplementing the usual care with the CardioCoach follow-up tool is feasible and safe, and whether the tool is more efficient in implementing the guideline recommendations for β-blocker and ACE-I. |
Keywords: | heart failure;telemedicine;clinical decision support;drug monitoring;drug utilization;call centers | Document URI: | http://hdl.handle.net/1942/30392 | ISSN: | 2561-1011 | DOI: | 10.2196/cardio.9153 | Rights: | Christophe JP Smeets, Valerie Storms, Pieter M Vandervoort, Pauline Dreesen, Julie Vranken, Marita Houbrechts, Hanne Goris, Lars Grieten, Paul Dendale. Originally published in JMIR Cardio (http://cardio.jmir.org), 04.04.2018. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Cardio, is properly cited. The complete bibliographic information, a link to the original publication on http://cardio.jmir.org, as well as this copyright and license information must be included. | Category: | A1 | Type: | Journal Contribution | Validations: | vabb 2021 |
Appears in Collections: | Research publications |
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