Home monitoring may help manage and reduce costs for heart failure

Dr. Gregg C. Fonarow

FINDINGS:
Heart failure affects 5.8 million people in the US alone and is responsible for nearly 1 million hospitalisations each year, most resulting from a build-up of body fluid in the lungs and other organs due to the heart's inability to pump effectively. The disease needs to be closely tracked in order to avoid such hospitalisations, and home-monitoring interventions may be especially useful, UCLA researchers say.

In their new paper, the UCLA authors discuss the importance of heart failure disease-management and early identification, as well as the treatment of body-fluid congestion, using a number of home-monitoring strategies, including self-care, such as daily weighing and medication management; phone calls from a nurse or automated response system; home health visits; and telemedicine and remote monitoring with implantable and external devices to track vital information.

IMPACT:

The field of heart failure home-monitoring is fairly new. Further study will help assess optimal approaches, such as identifying which patients may benefit the most from such monitoring, and will determine which health data - blood pressure or shortness of breath, for example may be the best to monitor. Promising new technologies, including devices to track heart-ventricle and pulmonary artery pressures, which are closely related to congestion development and clinical outcomes, may be particularly promising.

The authors suggest that the best approach is most likely multi-pronged, including monitoring along with patient follow-up and feedback.

UCLA is currently running Better Effectiveness After Transition-Heart Failure (BEAT-HF), a multicentre trial testing enhanced transitions of care and telemonitoring for patients recently hospitalised with heart failure.