Improving outpatient care for heart failure through digital innovation: A feasibility study

Abstract

Abstract Background: Heart failure (HF) affects over 26 million people worldwide. Multidisciplinary management strategies that include symptom monitoring and patient self-care support reduce HF hospitalization and mortality rates. Ideally, HF follow-up and self-care support includes lifestyle-change recommendations and remote monitoring of weight and HF symptoms. Providing these via a digital solution may be ideal for improving HF disease outcomes and reducing the burden on providers and healthcare systems. This study's main objective was to assess the feasibility of a digital solution including remote monitoring, lifestyle-change, and self-care support for HF outpatients in Iceland. Methods: Twenty HF patients (mean age 57.5 years, 80% males) participated in an 8-week study. They were provided with a digital solution (SK-141), including lifestyle-change and disease self-care support, a remote symptom monitoring system, and a secure messaging platform between healthcare providers and patients. This feasibility study aimed to assess patient acceptability of this new intervention, recruitment potential among patients in the HF clinic, retention rate, and to evaluate trends in clinical outcomes. To assess the acceptability of SK-141, participants completed a questionnaire about their experience after the 8-week study. Participants performed daily assigned activities (missions), including self-reporting symptoms. Clinical outcomes were assessed with the Hospital Anxiety and Depression Scale and the Kansas City Cardiomyopathy Questionnaire at the study's beginning and end with an online survey. Results: The retention rate of participants was high (80%) and participants rated the digital solution very highly with, e.g., a score of 6.8 out of 7 on their likelihood to recommend it to others. There was a trend towards improvement in all-but-one health-related variables logged in the digital solution from week 1 until week 8. Clinical outcomes revealed a positive trend for six out of seven variables, including for key heart failure variables such as shortness of breath, leg swelling, and fatigue. Conclusion: The digital solution, SK-141, was acceptable to patients and had promising results in this small feasibility study. These results encourage us to conduct a longer, more extensive, adequately powered, randomized-controlled study to assess whether this digital solution can improve quality of life and clinical outcomes among HF patients.