Chronic disease management in heart failure: focus on telemedicine and remote monitoring

Alvarez, Paulino; Sianis, Alex; Brown, Jessica; Ali, Abbas; Briasoulis, Αlexandros

doi:10.31083/j.rcm2202046

Cited by 51 publications

(27 citation statements)

References 88 publications

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“…A big novelty of the REMOTIVATE‐HF trial lies in the method of intervention administration. First, the sessions will be conducted remotely, with a series of advantages, such as extended access to care and higher flexibility in case of a need for frequent visits with healthcare professionals (Alvarez et al, 2021; Nardo et al, 2021). We opted for videoconferencing as this approach most closely resembles classic face‐to‐face visits.…”

Section: Discussionmentioning

confidence: 99%

Remote motivational interviewing to improve patient self‐care and caregiver contribution to self‐care in heart failure (REMOTIVATE‐HF): Rationale, design, and methodology for a multicentre randomized controlled trial

Vellone

Rebora

Iovino

et al. 2022

Research in Nursing & Health

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In patients with heart failure (HF), self‐care, and caregiver contribution to self‐care (i.e., the daily management of the disease by patients and caregivers) are essential for improving patient outcomes. However, patients and caregivers are often inadequate in their self‐care and contribution to self‐care, respectively, and struggle to perform related tasks. Face‐to‐face motivational interviewing (MI) effectively improves self‐care and caregiver contribution to self‐care, but the evidence on remote MI is scarce and inconclusive. The aims of this randomized controlled trial will be to evaluate whether remote MI performed via video call in patients with HF: (1) is effective at improving self‐care maintenance in patients (primary outcome); (2) is effective for the following secondary outcomes: (a) for patients: self‐care management, self‐care monitoring, and self‐efficacy; HF symptoms; generic and disease‐specific quality of life; anxiety and depression; use of healthcare services; and mortality; and (b) for caregivers: contribution to self‐care, self‐efficacy, and preparedness. We will conduct a two‐arm randomized controlled trial. We will enroll and randomize 432 dyads (patients and their informal caregivers) in Arm 1, in which patients and caregivers will receive MI or, in Arm 2, standard care. MI will be delivered seven times over 12 months. Outcomes will be assessed at baseline and 3 (primary outcome), 6, 9, and 12 months from enrollment. This trial will demonstrate whether an inexpensive and easily deliverable intervention can improve important HF outcomes. With the restrictions on in‐person healthcare professional interventions imposed by the COVID‐19 pandemic, it is essential to evaluate whether MI is also effective remotely.

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Section: Discussionmentioning

confidence: 99%

Remote motivational interviewing to improve patient self‐care and caregiver contribution to self‐care in heart failure (REMOTIVATE‐HF): Rationale, design, and methodology for a multicentre randomized controlled trial

Vellone

Rebora

Iovino

et al. 2022

Research in Nursing & Health

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“…These formats are fully complementary. [23][24][25] In fact, different studies have demonstrated that within the comprehensive management of patients with HF, the addition of telemedicine may result in better outcomes, including the prevention of further HF events and reduction of costs, regardless frailty status of patients. [26][27][28][29][30][31] Therefore, both, telemedicine and face-to-face visits are useful tools that can be adapted to the need that the patient require at each moment.…”

Section: Dovepressmentioning

confidence: 99%

Optimization of Patient Pathway in Heart Failure with Reduced Ejection Fraction and Worsening Heart Failure. Role of Vericiguat

González-Juanàtey¹,

Comín‐Colet²,

Pascual-Figal³

et al. 2023

PPA

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Heart failure (HF) is a progressive condition with periods of apparent stability and repeated worsening HF events. Over time, unless optimization of HF treatment, worsening HF events become more frequent and patients enter into a cycle of recurrent events with high morbidity and mortality. In patients with HF there is an activation of deleterious neurohormonal pathways, such as the renin angiotensin aldosterone system and the sympathetic system, and an inhibition of protective pathways, including natriuretic peptides and guanylate cyclase. Therefore, HF burden can be reduced only through a holistic approach that targets all neurohormonal systems. In this context, vericiguat may play a key role, as it is the only HF drug that activates the nitric oxide-soluble guanylate cyclase-cyclic guanosine monophosphate system. On the other hand, it has been described relevant disparities in the management of HF population. Consequently, it is necessary to homogenize the management of these patients, through an integrated patient-care pathway that should be adapted at the local level. In this context, the development of new technologies (ie, video call, specific platforms, remote control devices, etc.) may be very helpful. In this manuscript, a multidisciplinary group of experts analyzed the current evidence and shared their own experience to provide some recommendations about the therapeutic optimization of patients with recent worsening HF, with a particular focus on vericiguat, and also about how the integrated patient-care pathway should be performed.

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“…If not proactively addressed, these disparities may preclude equitable access to teleneurology services across diverse populations and potentially exacerbate pre-existing health care inequalities, particularly among underserved minority populations, elderly patients, and patients with low health literacy or digital literacy. 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 It is estimated that over one in four Americans lack access to requisite technologies or digital literacy to engage in telemedicine visits, raising concerns that patients who are most vulnerable and in need of enhanced health care access may be the ones who are least likely to benefit from the advent of telemedicine technologies. 90 These issues are further magnified in considering access to teleneurology in less developed countries.…”

Section: Justice and Equity In Teleneurologymentioning

confidence: 99%

Neuroethics in the Era of Teleneurology

Young

2022

Semin Neurol

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The accelerating integration of telehealth technologies in neurology practice has transformed traditional interactions between neurologists and patients, allied clinicians and society. Despite the immense promise of these technologies to improve systems of neurological care, the infusion of telehealth technologies into neurology practice introduces a host of unique ethical challenges. Proactive consideration of the ethical dimensions of teleneurology and of the impact of these innovations on the field of neurology more generally can help to ensure responsible development and deployment across stages of implementation. Toward these ends, this article explores key ethical dimensions of teleneurology practice and policy, presents a normative framework for their consideration, and calls attention to underexplored questions ripe for further study at this evolving nexus of teleneurology and neuroethics. To promote successful and ethically resilient development of teleneurology across diverse contexts, clinicians, organizational leaders, and information technology specialists should work closely with neuroethicists with the common goal of identifying and rigorously assessing the trajectories and potential limits of teleneurology systems.

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Chronic disease management in heart failure: focus on telemedicine and remote monitoring

Cited by 51 publications

References 88 publications

Remote motivational interviewing to improve patient self‐care and caregiver contribution to self‐care in heart failure (REMOTIVATE‐HF): Rationale, design, and methodology for a multicentre randomized controlled trial

Remote motivational interviewing to improve patient self‐care and caregiver contribution to self‐care in heart failure (REMOTIVATE‐HF): Rationale, design, and methodology for a multicentre randomized controlled trial

Optimization of Patient Pathway in Heart Failure with Reduced Ejection Fraction and Worsening Heart Failure. Role of Vericiguat

Neuroethics in the Era of Teleneurology

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