VA Home Telehealth Program for Initiating and Optimizing Heart Failure Guideline-Directed Medical Therapy

Abstract

Background: Heart failure (HF) is a chronic, progressive medical condition. Evidence suggests that guideline-directed medical therapy improves both morbidity and mortality in patients with HF with reduced ejection fraction when properly optimized. Unfortunately, many patients do not receive optimized therapy, highlighting the need to optimize clinicians' methods to more effectively and efficiently initiate and titrate medical therapy. Methods: This single-center, retrospective study evaluated the rates of drug interventions prompted by the home telehealth monitoring program for veterans with HF with reduced ejection fraction. Rates of drug interventions were evaluated among those who enrolled and those who did not enroll in the program. Results: There were 20 drug-related interventions in the home telehealth group compared with 11 interventions for the control group. One HF-related hospitalization occurred in the home telehealth program group compared with 6 in the control group. Conclusions: This study demonstrates the potential of home telehealth to optimize veterans' medication regimens and to reduce HF-related hospitalizations. It also provides an additional catalyst to further develop home telehealth services specifically targeted at drug therapy initiation and optimization in patients with HF with reduced ejection fraction.