Integrating remote monitoring into heart failure patients’ care regimen: A pilot study

Background: Heart failure is a debilitating disease affecting millions of adults in the United States, often leading to hospitalizations and hospital readmissions. Around 50% of readmissions due to heart failure are preventable, with lack of adherence to prescribed self-care as a driving factor. Remote tracking and reminders issued by mobile health devices such as activity trackers and smartphone apps could help to promote self-care, which could potentially reduce these readmissions. Objective: This pilot study used minimally-invasive monitoring technologies and patient-reported outcomes to examine the pragmatic feasibility of a remote monitoring regimen. Methods: Twenty heart failure patients participated in piloting a remote monitoring regimen. Data collection included: (1) continuous remote monitoring using wrist-worn consumer activity trackers; (2) body weight recording using bathroom scales; (3) dose tracking using smart pill bottles; and (4) patient-reported outcome measures. Results: Participants were aged 65.3 years on average, 50.0% of the participants were women, and 81.8% of the participants were determined to be New York Heart Association Class III or higher. Over the course of the study, 60.0% of the subjects wore the activity tracker for at least 70% of the hours, and 45.0% used the bathroom scale for more than 70% of the days. For the smart pill bottle, 55.0% of the subjects used it less than 10% of the days. Usage of the activity tracker correlated significantly with changes in Self-Care of Heart Failure Index confidence subscale scores and changes in Seattle Angina Questionnaire scores (P < .05), and usage of the bathroom scale correlated significantly with changes in Seattle Angina Questionnaire scores (P = .04). Conclusions: The majority of the participants maintained a high adherence to wearing the activity tracker, but had low adherence to using the smart pill bottle. Usage of the bathroom scale was fair, but it received positive reviews from most subjects. Given the observed usage and feedback, we suggest that mobile health-driven interventions consider including an activity tracker and bathroom scale. Furthermore, the data's correlations with changes in patient-reported outcomes indicate the potential for these devices to be an effective way to remotely monitor heart failure patients.