Heart failure Coach : pilot project mobile health to monitor patients with chronic heart failure at home.
12 December 2016
Thanks to a collaboration between Remedus, OLV Ziekenhuis Aalst and AZ Sint-Blasius Ronse, patients with chronic heart failure are being supported and coached more intensively at home via telemonitoring. This new approach with a crucial role for mobile health is the first step towards large-scale health-care projects for heart failure patients.
Why is telemonitoring so important for heart failure patients?
Heart failure is characterized by problematic fluid retention, which is a reaction of the body to restore the inadequate cardiac output by increasing the filling of the heart/ventricle. In an advanced stage of heart failure, this compensatory mechanism can lead to symptoms of dyspnea: the excess of accumulated fluid will cause pulmonary or peripheral edema. To prevent that, correctly dosed diuretic therapy is crucial in heart failure treatment, next to beta-blockers and ACE inhibitors which are important as regards the prognosis. Therefore, it is extremely important that heart failure patients take their medication as prescribed. It is also important that they ring the alarm bell if their symptoms get worse. Still, that is not easy for every patient.
Telemonitoring helps patients to bring problems to light faster. That allows for more rapid treatment (for example through medication adjustment), so the patient always receives the optimal treatment.
What does the Heart failure Coach program include?
After the cardiologist in attendance has signed up the patient for the program, one of Remedus’s nurses will visit the patient at home once. During this visit, the nurse will explain how the scales and the blood pressure and heart rate monitor work, as well as the RemeCare app. Further, the patient will be asked to make a minimal effort for six months: to measure his of her weight and blood pressure daily ánd to register his or her medication intake. Weight is the most sensitive parameter to detect imminent decompensation. All this information will be sent in real time to the health-care providers involved at the hospital.
In the case of several consecutive days of crossing the threshold values, the patient has to fill out a questionnaire via the smartphone application, to check if there are other external causes of the sudden increase: has the patient been drinking more, has he or she not been taking the diuretics, or has he or she not been weighing himself or herself correctly? If those causes have been ruled out, the patient will be contacted by the heart failure nurse by telephone. In consultation with the cardiologist, the heart failure nurse and the patient, a solution will be looked for: adjustment of nutrition or fluid intake, change of medication, early consultation with family doctor or cardiologist.
During 6 months, 99 patients were followed. Therapy adherence to heart failure medication rates amounted to more than 90%. The response rate of the daily weight, blood pressure and heart rate measurements was very high (> 95%). Because the patient feels involved in the success of his or her treatment, his or her therapy adherence automatically increases. Through daily measurements, the patient participates in his or her own recovery.
- OLV Ziekenhuis Aalst
- AZ Sint-Blasius Ronse
- Wit-Gele Kruis Oost-Vlaanderen