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Determine Return on Investment in Heart Failure Remote Monitoring Program

Not Applicable
Conditions
Heart Failure
Interventions
Device: Peripherals with HealthInterlink technology
Registration Number
NCT02475577
Lead Sponsor
NCH Heatlhcare System Inc
Brief Summary

The study will test a hypothesis that the remote monitoring with text and email alerts sent to study subject and optional family/other caregiver (Intervention 1) will have a higher return on investment compared to remote monitoring with nurse researcher follow-up telephone communication to study subject (on Blue alerts) or study subject's healthcare professional (on Red alerts) (Intervention 2) and self-monitoring without intervention (Control).

Detailed Description

The objective of this remote monitoring study is to evaluate return on investment and end-user clinical outcomes associated with the use of self-monitoring peripherals and tablet/smartphone-based Welch Allyn HealthInterlink technology without intervention (Control), HealthInterlink remote monitoring with text and email alerts sent to study subject and optional family/other caregiver (Intervention 1), and HealthInterlink remote monitoring with nurse research assistant follow-up telephone communication to study subject (on Blue alerts) or study subject's healthcare professional (on Red alerts) (Intervention 2 added to Intervention 1).

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
163
Inclusion Criteria
  • Absence of significant vision, hearing, or other communication deficits
  • English speaking;
  • Capable and willing to give informed consent;
  • Participated in the in-patient heart failure class within the last three months. Acceptable candidate for elective, non-emergent, remote monitoring as determined by ordering physician;
  • Living in a private home;
  • Hospital admission for Heart Failure or decompensation in the previous 12 months
  • New York Heart Association (NYHA) classes II-IV, as assigned by the nurse researcher, trained by a cardiologist
  • Cardiac aetiology: ischaemic, idiopathic, hypertensive, or valvular
  • Left ventricular ejection fraction <40% s an index of systolic dysfunction, combined or not with a left ventricular filling pattern supporting the presence of diastolic dysfunction, according to the American College of Cardiology/American Heart Association Guidelines for chronic heart failure.

or

  • NYHA class II-III who had an ejection fraction >40% and evidence of diastolic left ventricular dysfunction.
  • Optional subject with a diagnosis of diabetes (indicated by HbA1c >7).
Exclusion Criteria
  • Currently involved in other investigational clinical trials (unless permission is granted by other study PI);
  • Females who are pregnant, planning to become pregnant within 3 months, or lactating;
  • Requirement for emergent placement other than private home (subject's condition would be compromised if there is a delay in placement).
  • Myocardial infarction, revascularization or Implantable Cardioverter Defibrillator (ICD) implantation in the previous 6 months angina or objective myocardial ischaemia requiring future revascularization implanted ventricular or atrial pacemaker (except dual chamber ICD pacemakers with good sinus activity);
  • End-stage heart failure requiring regular inotropic drug infusions;
  • Chronic renal failure requiring dialysis treatment and
  • Unstable angina.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ControlPeripherals with HealthInterlink technologyControl: Peripherals with HealthInterlink technology will record and transmit data, without intervention. Subject is able to view graphed data, bring the HealthInterlink tablet/smartphone to the physician's office and share data with family/other caregiver.
Intervention 2Peripherals with HealthInterlink technologyIntervention 2: Peripherals with HealthInterlink technology will record and transmit data and send out-of-range data (Red) alerts to subject via HealthInterlink tablet/smartphone and also text/email to family/other caregiver, and nonconformity (Blue) alerts to subject's personal text/email and also text/email to family/other caregiver, and a call will be placed by the nurse research assistant to study subject (on Blue alerts) or study subject's healthcare professional (on Red alerts). The physicians will have access to the subject's data on a web-based program.
Intervention 1Peripherals with HealthInterlink technologyIntervention 1: Peripherals with HealthInterlink technology will record and transmit data and send out-of-range data (Red) alerts to subject via HealthInterlink tablet/smartphone and also text/email to family/other caregiver, and nonconformity (Blue) alerts to subject's personal text/email and also text/email to family/other caregiver.
Primary Outcome Measures
NameTimeMethod
Number of subjects with unplanned re- hospitalization (heart failure-related and other hospitalization)31 days

31 days post discharge with a heart failure-related hospital re-hospitalization.

Secondary Outcome Measures
NameTimeMethod
Health-related quality of life Questionnaire31 days

Health-related quality of life

Communication with healthcare provider or emergency department31 days

Communication that resulted in unplanned healthcare provider office visits or visit to emergency department

Number of non-conformity issues31 days

Number of non-conformity telephone reminder texts, emails, and/or calls.

Physician satisfaction Questionnaire31 days

Physician satisfaction for peripherals and HealthInterlink tablet/ smartphone judged to be reliable and robust, ease of use of software, benefit that promoted better communication with subject.

Cost of system and intervention per subjects31 days

Economic viability of remote monitoring program based on daily cost of system and intervention per subjects in comparison with control and treatment groups.

Subject satisfaction Questionnaire31 days

Subject satisfaction for peripherals and HealthInterlink tablet/ smartphone judged to be reliable and robust, ease of use, time to complete testing and questionnaire, benefit that promoted better health

Trial Locations

Locations (1)

NCH Healthcare System

🇺🇸

Naples, Florida, United States

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