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

• Published in: PloS one Vol. 15; no. 11; p. e0242210
• Main Authors: Sohn, Albert, Speier, William, Lan, Esther, Aoki, Kymberly, Fonarow, Gregg C., Ong, Michael K., Arnold, Corey W.
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 19.11.2020; Public Library of Science (PLoS)
• Subjects: Activity trackers; Aged; Aged, 80 and over; Balances (scales); Bathrooms; Biology and Life Sciences; Body Weight; Care and treatment; Congestive heart failure; Data collection; Electronic devices; Engineering and Technology; Enrollments; Exercise; Feasibility; Female; Health aspects; Health services; Heart failure; Heart Failure - pathology; Heart rate; Humans; Informed consent; Internal medicine; Male; Medication Adherence; Medicine; Medicine and Health Sciences; Methods; Middle Aged; Monitoring, Physiologic - methods; Outcome Assessment, Health Care; Patient compliance; Patients; Physical activity; Physiologic monitoring; Pilot Projects; Polls & surveys; Remote monitoring; Remote sensors; Research and Analysis Methods; Self care (Health); Self Report; Sensors; Smartphones; Technology application; Telemedicine; Tracking devices; Wearable Electronic Devices; Wireless Technology; Wrist; United States; Los Angeles California; United States > US; California
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0242210

Around 50% of hospital 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 could help to promote self-care, which could potentially reduce these readmissions. We sought to investigate two factors: (1) feasibility of enrolling heart failure patients in a remote monitoring regimen that uses wireless sensors and patient-reported outcome measures; and (2) their adherence to using the study devices and completing patient-reported outcome measures. Twenty heart failure patients participated in piloting a remote monitoring regimen. Data collection included: (1) physical activity using wrist-worn activity trackers; (2) body weight using bathroom scales; (3) medication adherence using smart pill bottles; and (4) patient -reported outcomes using patient-reported outcome measures. We evaluated 150 hospitalized heart failure patients and enrolled 20 individuals. Two factors contributed to 50% (65/130) being excluded from the study: smartphone ownership and patient discharge. 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 scale for more than 70% of the days. The pill bottle was used less than 10% of the days by 55.0% of the subjects. Our method of recruiting heart failure patients prior to hospital discharge may not be feasible as the enrollment rate was low. Once enrolled, the majority of subjects maintained a high adherence to wearing the activity tracker but low adherence to using the pill bottle and completing the follow-up surveys. Scale usage was fair, but it received positive reviews from most subjects. Given the observed usage and feedback, we suggest mobile health-driven interventions consider including an activity tracker and bathroom scale. We also recommend administering a shorter survey more regularly and through an easier interface.