Smart and Healthy Ageing Through People Engaging in Supportive Systems (SHAPES) Digital App and Platform for Supporting Medicines Control and Optimization in Older Individuals With Heart Failure

INTRODUCTION AND FINDINGS People who are aged 65 years and older account for almost a fifth of the population of the European Union. The number of people in this age group is projected to reach 151 million in 2060. Thus, there is an imperative to keep people healthy and active as they age. As age increases, however, so too does the prevalence of people living with long term conditions and subsequently, the number and complexity of treatment regimens to manage those conditions, also known as polypharmacy. In addition, the location of care delivery is also adapting - shifting routine care from hospitals to homes and the community. Home is a more comfortable and familiar setting for people and, as it has been the case during the COVID-19 pandemic, home is safer too. Individuals with chronic health conditions require regular and specialist care and support. The use of information and communication technologies (eHealth) offers opportunities to support and enhance home care.

Health literacy and individual involvement will be key elements in the successful introduction of eHealth into the health and social care system. The Smart & Healthy Ageing through People Engaging in Supportive Systems (SHAPES) Innovation Action (www.shapes2020.eu), a European project in which HUMANA GROUP is a member, intends to build, pilot and deploy a large-scale, EU-standardised open platform. SHAPES large-scale piloting campaign will engage +2k older individuals in 15 pilot sites in 10 EU Member States, including six European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) Reference Sites, and involve hundreds of key stakeholders. SHAPES multidisciplinary approach to large-scale piloting is reflected across seven themes that, together, provide a clear understanding of the reality of European health and care systems and enable the validation of cost-efficient, interoperable and reliable innovations capable of effectively supporting healthy and independent living of older individuals within and outside the home.

The Medicines Optimisation Innovation Centre (MOIC), which is hosted by the Northern Health and Social Care Trust (NHSCT) is an EIP on AHA reference site and is dedicated to driving innovation in medicines use. The MOIC is leading Pilot Theme 3 of the SHAPES pilot: 'Medicines control and optimisation', wherein the SHAPES platform and selected digital solutions will be used to help participants self-monitor their health condition(s), physiological parameters and medicines adherence. Within this pilot theme there are multiple 'use cases' each deploying and evaluating different digital solutions in several European countries according to the type of support required. Four use cases will be used to evaluate this pilot theme. The project in this document describes the piloting of the use case led by CLINIKA DE KAY and carried out in Mallorca, Spain.

The use case of this project study focuses on older persons with a heart failure condition in stages 2 (patients have minor limitations while performing physical activities) or 3 (minimal ordinary activity results in weakness). Main symptom which limits quality of life is shortness of breath when patient exerts themselves or even at rest. It reduces capacity of patient to perform daily activities. An optimal management of the disease by patients is essential to prevent decompensation, a sudden functional deterioration of the heart that may lead to hospitalisation.

The combination of multiple medicines along with, many times, a change in life-style makes the management of the disease difficult. In addition, factors associated with age increase the complexity for older individuals. Adherence to treatment and life-style is usually not optimal. Finally, many individuals of this group should go to medicine reconciliation, a process which is not widely extended in health services.