The Effects of Telemonitoring on Patient Compliance With Self-Management Recommendations and Outcomes of the Innovative Telemonitoring Enhanced Care Program for Chronic Heart Failure: Randomized Controlled Trial

Ding, Hang; Jayasena, Rajiv; Chen, Sheau Huey; Maiorana, Andrew; Dowling, Alison; Layland, Jamie; Good, Norm; Karunanithi, Mohanraj; Edwards, Iain

doi:10.2196/17559

Cited by 74 publications

(99 citation statements)

References 31 publications

(42 reference statements)

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“…Telemedicine contributing to lifestyle improvement has been confirmed in other domains of medicine [ 50 - 56 ]. On the one hand, telemedicine provides patients and their caregivers with sustaining education on the necessity of lifestyle alterations [ 50 , 57 ]. On the other hand, timely feedback from clinicians enhances patients’ motivation to change their unhealthy lifestyles [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

The Hospital-Community-Family–Based Telemedicine (HCFT-AF) Program for Integrative Management of Patients With Atrial Fibrillation: Pilot Feasibility Study

Jiang

Cheng

et al. 2020

JMIR Mhealth Uhealth

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Background The potential effectiveness of integrated management in further improving the prognosis of patients with atrial fibrillation has been demonstrated; however, the best strategy for implementation remains to be discovered. Objective The aim of this study was to ascertain the feasibility of implementing integrated atrial fibrillation care via the Hospital-Community-Family–Based Telemedicine (HCFT-AF) program. Methods In this single-arm, pre-post design pilot study, a multidisciplinary teamwork, supported by efficient infrastructures, provided patients with integrated atrial fibrillation care following the Atrial fibrillation Better Care (ABC) pathway. Eligible patients were continuously recruited and followed up for at least 4 months. The patients’ drug adherence, and atrial fibrillation–relevant lifestyles and behaviors were assessed at baseline and at 4 months. The acceptability, feasibility, and usability of the HCFT-AF technology devices and engagement with the HCFT-AF program were assessed at 4 months. Results A total of 73 patients (mean age, 68.42 years; 52% male) were enrolled in November 2019 with a median follow up of 132 days (IQR 125–138 days). The patients’ drug adherence significantly improved after the 4-month intervention (P<.001). The vast majority (94%, 64/68) of indicated patients received anticoagulant therapy at 4 months, and none of them received antiplatelet therapy unless there was an additional indication. The atrial fibrillation–relevant lifestyles and behaviors ameliorated to varying degrees at the end of the study. In general, the majority of patients provided good feedback on the HCFT-AF intervention. More than three-quarters (76%, 54/71) of patients used the software or website more than once a week and accomplished clinic visits as scheduled. Conclusions The atrial fibrillation–integrated care model described in this study is associated with improved drug adherence, standardized therapy rate, and lifestyles of patients, which highlights the possibility to better deliver integrated atrial fibrillation management. Trial Registration Clinicaltrials.gov NCT04127799; https://clinicaltrials.gov/ct2/show/NCT04127799

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Section: Discussionmentioning

confidence: 99%

The Hospital-Community-Family–Based Telemedicine (HCFT-AF) Program for Integrative Management of Patients With Atrial Fibrillation: Pilot Feasibility Study

Jiang

Cheng

et al. 2020

JMIR Mhealth Uhealth

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“…In total, 30 studies investigating non-invasive telemonitoring have been identified, including a total of 8892 patients [ 24 , 32 , 42 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 ]. The study characteristics, as well as the reported outcomes on all-cause mortality, all-cause hospitalization, and HF-related hospitalization rates of the five largest studies, representing 52% (4606) of all patients, will be discussed in detail below [ 24 , 51 , 52 , 61 , 64 ].…”

Section: Non-invasive Telemonitoring Versus Usual Carementioning

confidence: 99%

“…The study characteristics, as well as the reported outcomes on all-cause mortality, all-cause hospitalization, and HF-related hospitalization rates of the five largest studies, representing 52% (4606) of all patients, will be discussed in detail below [ 24 , 51 , 52 , 61 , 64 ]. The study characteristics and outcomes of the other 25 studies will be summarized below [ 32 , 42 , 47 , 48 , 49 , 50 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 62 , 63 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 ].…”

Section: Non-invasive Telemonitoring Versus Usual Carementioning

confidence: 99%

“…Twelve of these other studies reported data on monitoring adherence, ranging from 46% up to 95% [ 47 , 48 , 50 , 54 , 55 , 56 , 59 , 60 , 63 , 65 , 69 , 73 ]. Importantly to note, the monitoring strategy’s adherence decreased when the patients had to perform multiple measurements [ 48 , 50 , 73 ]. Additionally, the adherence decreased over time [ 48 , 50 , 55 , 56 ].…”

Section: Non-invasive Telemonitoring Versus Usual Carementioning

confidence: 99%

“…Importantly to note, the monitoring strategy’s adherence decreased when the patients had to perform multiple measurements [ 48 , 50 , 73 ]. Additionally, the adherence decreased over time [ 48 , 50 , 55 , 56 ]. Surprisingly, the adherence also decreased in the weeks after hospitalization [ 47 ].…”

Section: Non-invasive Telemonitoring Versus Usual Carementioning

confidence: 99%

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Remote Monitoring in Chronic Heart Failure Patients: Is Non-Invasive Remote Monitoring the Way to Go?

Veenis

Radhoe

Hooijmans

et al. 2021

Sensors

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Heart failure (HF) is a major health care issue, and the incidence of HF is only expected to grow further. Due to the frequent hospitalizations, HF places a major burden on the available hospital and healthcare resources. In the future, HF care should not only be organized solely at the clinical ward and outpatient clinics, but remote monitoring strategies are urgently needed to guide, monitor, and treat chronic HF patients remotely from their homes as well. The intuitiveness and relatively low costs of non-invasive remote monitoring tools make them an appealing and emerging concept for developing new medical apps and devices. The recent COVID-19 pandemic and the associated transition of patient care outside the hospital will boost the development of remote monitoring tools, and many strategies will be reinvented with modern tools. However, it is important to look carefully at the inconsistencies that have been reported in non-invasive remote monitoring effectiveness. With this review, we provide an up-to-date overview of the available evidence on non-invasive remote monitoring in chronic HF patients and provide future perspectives that may significantly benefit the broader group of HF patients.

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Assessment of US Food and Drug Administration–Approved Digital Medical Devices for Just-in-Time Interventions

et al. 2023

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ImportanceJust-in-time interventions (JITIs) are a type of digital therapeutic intervention that combines remote monitoring tools and algorithms to personalize the delivery of specific interventions at the right time. The US Food and Drug Administration (FDA) regulatory approval documents are often the only available source of information on the effectiveness of therapeutic interventions based on these devices.ObjectiveTo systematically review the publicly available information from the FDA on all recently approved medical devices used in JITIs to (1) assess how they operate to deliver JITIs and (2) appraise the evidence supporting their performance and clinical effectiveness.Evidence ReviewTwo reviewers systematically searched the Premarket Notifications (510(k)), Premarket Approvals, De Novo, and Humanitarian Device Exemption databases from January 2019 to December 2021 for all entries associated with devices that monitored patients’ data over time to personalize the delivery of interventions to treat, prevent, or mitigate health conditions or events. They assessed whether the product summaries (1) enabled an understanding of how the device operated to deliver a JITI (eg, the nature, type, and frequency of the monitoring, the nature of the decision algorithm, and the nature and intended receiver of the intervention); (2) informed about the performance and effectiveness of the JITI; and (3) included information on data security and ownership.FindingsIn total, 38 devices were included in this review. These were mainly intended for cardiac conditions (12 [31.6%]), diabetes (10 [26.3%]), and neurological diseases (4 [10.5%]). Monitoring devices ranged from wearable (18 of 28 [64.4%]; eg, smartwatches) to implanted sensors (6 of 28 [21.4%]; eg, inserted electrocardiographic sensors). Only 10 of 38 product summaries (26.3%) allowed a full understanding of how the device operated to deliver a JITI. Similarly, only 12 of 28 (42.9%), 12 of 36 (33.3%), and 5 of 38 (13.2%) reported the assessment of the performance of the monitoring device, assessment of the decision algorithm, and results of clinical studies assessing the effectiveness of the JITI, respectively. Finally, 14 of 36 product summaries (38.9%) included some information on data security, but none included information on data ownership.Conclusion and RelevanceThe results of this systematic review suggest that the information publicly available in the FDA databases on the performance and effectiveness of digital medical devices used in JITIs is heterogeneous.

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The Effects of Telemonitoring on Patient Compliance With Self-Management Recommendations and Outcomes of the Innovative Telemonitoring Enhanced Care Program for Chronic Heart Failure: Randomized Controlled Trial

Cited by 74 publications

References 31 publications

The Hospital-Community-Family–Based Telemedicine (HCFT-AF) Program for Integrative Management of Patients With Atrial Fibrillation: Pilot Feasibility Study

The Hospital-Community-Family–Based Telemedicine (HCFT-AF) Program for Integrative Management of Patients With Atrial Fibrillation: Pilot Feasibility Study

Remote Monitoring in Chronic Heart Failure Patients: Is Non-Invasive Remote Monitoring the Way to Go?

Assessment of US Food and Drug Administration–Approved Digital Medical Devices for Just-in-Time Interventions

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