mHealth Remote Patient Monitoring Improves Heart Failure Management and Outcomes: A Randomized Controlled Trial
Remote patient monitoring of heart failure patients has been shown to improve health outcomes. However, the efficacy of a mobile phone-based remote patient monitoring system for heart failure is unknown.
The remote monitoring (RM) group (N=50) took daily weight and blood pressure readings, weekly single-lead ECGs, and answered daily yes/no symptom questions on a mobile phone. Readings were automatically transmitted wirelessly to the mobile phone and then to data servers. Alerts were sent to the patients and clinicians as required. The control group (N=50) was provided with standard of care. Patients were followed for 6 months. Paired Student t-tests were performed on baseline and post-study blood tests and survey data.
Approximately 70% of RM patients completed at least 80% of their daily readings over the 6 months. The Brain Natriuretic Peptide (BNP) blood tests improved significantly only for the RM group (decrease of 186 pg/mL, p=0.01). Quality of life (Minnesota Living with Heart Failure Questionnaire) also improved only for the RM group (decrease of 14 points, p=0.006). Self-care maintenance (Self-Care of Heart Failure Index) had a clinically significant change for the RM group (p=0.004). No significant decrease in hospitalization was found in the RM (decrease of 0.2 times, p=0.4) likely due to several patients in the RM group being instructed by their healthcare providers to go to the emergency department, which led to hospital admissions.
mHealth systems are a scalable and cost-effective form of remote patient monitoring. In this study, we showed that a mobile phone-based remote monitoring system improved heart function (as measured through BNP), quality of life, and self-care. To achieve these positive outcomes, we hypothesize that an initial increase in hospitalization may be required to realize long-term savings.
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