Potential role for clinical calibration to increase engagement with and application of home telemonitoring: a report from the HeartCycle programme

Abstract

AimsThere is a need for alternative strategies that might avoid recurrent admissions in patients with heart failure. home telemonitoring (HTM) to monitor patient's symptoms from a distance may be useful. This study attempts to assess changes in HTM vital signs in response to daily life activities (variations in medication, salt intake, exercise, and stress) and to establish which variations affect weight, blood pressure, and heart rate.Methods and resultsWe assessed 76 patients with heart failure (mean age 76 ± 10.8 years, 75% male, mainly in NYHA class II/III and from ischaemic aetiology cause). Patients were given a calendar of interventions scheduling activities approximately twice a week before measuring their vital signs. Eating salty food or a large meal were the activities that had a significant impact on weight gain (+0.3 kg; P < 0.001 and P = 0.006, respectively). Exercise and skipping a dose of medication other than diuretics increased heart rate (+3 bpm, P = 0.001 and almost +2 bpm, P = 0.016, respectively).ConclusionsOur HTM system was able to detect small changes in vital signs related to these activities. Further studies should assess if providing such a schedule of activities might be useful for patient education and could improve long‐term adherence to recommended lifestyle changes.

Caring for people with heart failure and many other medical problems through and beyond the COVID‐19 pandemic: the advantages of universal access to home telemonitoring

“…Patients often get bored with telemonitoring systems that provide no feedback and do not seem to 'do' anything. A health maintenance strategy provides much greater patient engagement and motivation through both education and patient action 12,13. Educating patients, empathetically, about what treatment targets should be achieved, whether that is weight, heart rate or blood pressure, empowers them to participate in the development and delivery of care.…”