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Patient Perspectives on Digital Interventions to Manage Heart Failure Medications: The VITAL-HF Pilot

Use of guideline-directed medical therapy (GDMT) for treatment of heart failure with reduced ejection fraction (HFrEF) remains unacceptably low. The purpose of this study was to determine whether a digital health tool can augment GDMT for patients with HFrEF. Participants ≥ 18 years old with symptom...

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Autores principales: Samsky, Marc D., Leverty, Renee, Gray, James M., Davis, Alexandra, Fisher, Brett, Govil, Ashul, Stanis, Tom, DeVore, Adam D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380884/
https://www.ncbi.nlm.nih.gov/pubmed/37510791
http://dx.doi.org/10.3390/jcm12144676
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author Samsky, Marc D.
Leverty, Renee
Gray, James M.
Davis, Alexandra
Fisher, Brett
Govil, Ashul
Stanis, Tom
DeVore, Adam D.
author_facet Samsky, Marc D.
Leverty, Renee
Gray, James M.
Davis, Alexandra
Fisher, Brett
Govil, Ashul
Stanis, Tom
DeVore, Adam D.
author_sort Samsky, Marc D.
collection PubMed
description Use of guideline-directed medical therapy (GDMT) for treatment of heart failure with reduced ejection fraction (HFrEF) remains unacceptably low. The purpose of this study was to determine whether a digital health tool can augment GDMT for patients with HFrEF. Participants ≥ 18 years old with symptomatic HFrEF (left ventricular ejection fraction ≤ 40%) and with access to a mobile phone with internet were included. Participants were given a blood pressure cuff, instructed in its use, and given regular symptom surveys via cell-phone web-link. Data were transmitted to the Story Health web-based platform, and automated alerts were triggered based on pre-specified vital sign and laboratory data. Health coaches assisted patients with medication education, pharmacy access, and lab access through text messages and phone calls. GDMT titration plans were individually created in the digital platform by local clinicians based on entry vitals and labs. Twelve participants enrolled and completed the study. The median age and LVEF were 52.5 years (IQR, 46.5–63.5) and 25% (IQR, 22.5–35.5), respectively. There were 10 GDMT initiations, 52 up-titrations, and 13 down-titrations. Five participants engaged in focus-group interviews following study completion to understand first-hand perspectives regarding the use of digital tools to manage GDMT. Participants expressed comfort knowing that there were clinicians regularly reviewing their data. This alleviated concerns of uncertainty in daily living, led to an increased feeling of security, and empowered patients to understand decision-making regarding GDMT. Frequent medication changes, and the associated financial impact, were common concerns. Remote titration of GDMT for HFrEF is feasible and appears to be a patient-centered approach to care.
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spelling pubmed-103808842023-07-29 Patient Perspectives on Digital Interventions to Manage Heart Failure Medications: The VITAL-HF Pilot Samsky, Marc D. Leverty, Renee Gray, James M. Davis, Alexandra Fisher, Brett Govil, Ashul Stanis, Tom DeVore, Adam D. J Clin Med Article Use of guideline-directed medical therapy (GDMT) for treatment of heart failure with reduced ejection fraction (HFrEF) remains unacceptably low. The purpose of this study was to determine whether a digital health tool can augment GDMT for patients with HFrEF. Participants ≥ 18 years old with symptomatic HFrEF (left ventricular ejection fraction ≤ 40%) and with access to a mobile phone with internet were included. Participants were given a blood pressure cuff, instructed in its use, and given regular symptom surveys via cell-phone web-link. Data were transmitted to the Story Health web-based platform, and automated alerts were triggered based on pre-specified vital sign and laboratory data. Health coaches assisted patients with medication education, pharmacy access, and lab access through text messages and phone calls. GDMT titration plans were individually created in the digital platform by local clinicians based on entry vitals and labs. Twelve participants enrolled and completed the study. The median age and LVEF were 52.5 years (IQR, 46.5–63.5) and 25% (IQR, 22.5–35.5), respectively. There were 10 GDMT initiations, 52 up-titrations, and 13 down-titrations. Five participants engaged in focus-group interviews following study completion to understand first-hand perspectives regarding the use of digital tools to manage GDMT. Participants expressed comfort knowing that there were clinicians regularly reviewing their data. This alleviated concerns of uncertainty in daily living, led to an increased feeling of security, and empowered patients to understand decision-making regarding GDMT. Frequent medication changes, and the associated financial impact, were common concerns. Remote titration of GDMT for HFrEF is feasible and appears to be a patient-centered approach to care. MDPI 2023-07-14 /pmc/articles/PMC10380884/ /pubmed/37510791 http://dx.doi.org/10.3390/jcm12144676 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Samsky, Marc D.
Leverty, Renee
Gray, James M.
Davis, Alexandra
Fisher, Brett
Govil, Ashul
Stanis, Tom
DeVore, Adam D.
Patient Perspectives on Digital Interventions to Manage Heart Failure Medications: The VITAL-HF Pilot
title Patient Perspectives on Digital Interventions to Manage Heart Failure Medications: The VITAL-HF Pilot
title_full Patient Perspectives on Digital Interventions to Manage Heart Failure Medications: The VITAL-HF Pilot
title_fullStr Patient Perspectives on Digital Interventions to Manage Heart Failure Medications: The VITAL-HF Pilot
title_full_unstemmed Patient Perspectives on Digital Interventions to Manage Heart Failure Medications: The VITAL-HF Pilot
title_short Patient Perspectives on Digital Interventions to Manage Heart Failure Medications: The VITAL-HF Pilot
title_sort patient perspectives on digital interventions to manage heart failure medications: the vital-hf pilot
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380884/
https://www.ncbi.nlm.nih.gov/pubmed/37510791
http://dx.doi.org/10.3390/jcm12144676
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