Journal Article

Integrating remote monitoring into heart failure patients’ care regimen: A pilot study

Speier, William, Sohn, Albert, Aoki, Kymberly, Lan, Esther, Arnold, Corey W., Ong, Michael K., Fonarow, Gregg C.

2020

Overview

Around 50% of hospital readmissions due to heart failure are preventable, with lack of adherence to prescribed self-care as a driving factor. Remote tracking and reminders issued by mobile health devices could help to promote self-care, which could potentially reduce these readmissions. We sought to investigate two factors: (1) feasibility of enrolling heart failure patients in a remote monitoring regimen that uses wireless sensors and patient-reported outcome measures; and (2) their adherence to using the study devices and completing patient-reported outcome measures. Twenty heart failure patients participated in piloting a remote monitoring regimen. Data collection included: (1) physical activity using wrist-worn activity trackers; (2) body weight using bathroom scales; (3) medication adherence using smart pill bottles; and (4) patient -reported outcomes using patient-reported outcome measures. We evaluated 150 hospitalized heart failure patients and enrolled 20 individuals. Two factors contributed to 50% (65/130) being excluded from the study: smartphone ownership and patient discharge. Over the course of the study, 60.0% of the subjects wore the activity tracker for at least 70% of the hours, and 45.0% used the scale for more than 70% of the days. The pill bottle was used less than 10% of the days by 55.0% of the subjects. Our method of recruiting heart failure patients prior to hospital discharge may not be feasible as the enrollment rate was low. Once enrolled, the majority of subjects maintained a high adherence to wearing the activity tracker but low adherence to using the pill bottle and completing the follow-up surveys. Scale usage was fair, but it received positive reviews from most subjects. Given the observed usage and feedback, we suggest mobile health-driven interventions consider including an activity tracker and bathroom scale. We also recommend administering a shorter survey more regularly and through an easier interface.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Activity trackers / Aged / Aged, 80 and over / Balances (scales) / Bathrooms / Biology and Life Sciences / Body Weight / Care and treatment / Congestive heart failure / Data collection / Electronic devices / Engineering and Technology / Enrollments / Exercise / Feasibility / Female / Health aspects / Health services / Heart failure / Heart Failure - pathology / Heart rate / Humans / Informed consent / Internal medicine / Male / Medication Adherence / Medicine / Medicine and Health Sciences / Methods / Middle Aged / Monitoring, Physiologic - methods / Outcome Assessment, Health Care / Patient compliance / Patients / Physical activity / Physiologic monitoring / Pilot Projects / Polls & surveys / Remote monitoring / Remote sensors / Research and Analysis Methods / Self care (Health) / Self Report / Sensors / Smartphones / Technology application / Telemedicine / Tracking devices / Wearable Electronic Devices / Wireless Technology / Wrist