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@article{Zaman:2023:10.2196/45611,
author = {Zaman, S and Padayachee, Y and Shah, M and Samways, J and Auton, A and Quaife, NM and Sweeney, M and Howard, JP and Tenorio, I and Bachtiger, P and Kamalati, T and Pabari, PA and Linton, NWF and Mayet, J and Peters, NS and Barton, C and Cole, GD and Plymen, CM},
doi = {10.2196/45611},
journal = {JMIR Cardio},
title = {Smartphone-based remote monitoring in heart failure with reduced ejection fraction: retrospective cohort study of secondary care use and costs},
url = {http://dx.doi.org/10.2196/45611},
volume = {7},
year = {2023}
}

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TY  - JOUR
AB  - BACKGROUND: Despite effective therapies, the economic burden of heart failure with reduced ejection fraction (HFrEF) is driven by frequent hospitalizations. Treatment optimization and admission avoidance rely on frequent symptom reviews and monitoring of vital signs. Remote monitoring (RM) aims to prevent admissions by facilitating early intervention, but the impact of noninvasive, smartphone-based RM of vital signs on secondary health care use and costs in the months after a new diagnosis of HFrEF is unknown. OBJECTIVE: The purpose of this study is to conduct a secondary care health use and health-economic evaluation for patients with HFrEF using smartphone-based noninvasive RM and compare it with matched controls receiving usual care without RM. METHODS: We conducted a retrospective study of 2 cohorts of newly diagnosed HFrEF patients, matched 1:1 for demographics, socioeconomic status, comorbidities, and HFrEF severity. They are (1) the RM group, with patients using the RM platform for >3 months and (2) the control group, with patients referred before RM was available who received usual heart failure care without RM. Emergency department (ED) attendance, hospital admissions, outpatient use, and the associated costs of this secondary care activity were extracted from the Discover data set for a 3-month period after diagnosis. Platform costs were added for the RM group. Secondary health care use and costs were analyzed using Kaplan-Meier event analysis and Cox proportional hazards modeling. RESULTS: A total of 146 patients (mean age 63 years; 42/146, 29% female) were included (73 in each group). The groups were well-matched for all baseline characteristics except hypertension (P=.03). RM was associated with a lower hazard of ED attendance (hazard ratio [HR] 0.43; P=.02) and unplanned admissions (HR 0.26; P=.02). There were no differences in elective admissions (HR 1.03, P=.96) or outpatient use (HR 1.40; P=.18) between the 2 groups. These differences were sustai
AU  - Zaman,S
AU  - Padayachee,Y
AU  - Shah,M
AU  - Samways,J
AU  - Auton,A
AU  - Quaife,NM
AU  - Sweeney,M
AU  - Howard,JP
AU  - Tenorio,I
AU  - Bachtiger,P
AU  - Kamalati,T
AU  - Pabari,PA
AU  - Linton,NWF
AU  - Mayet,J
AU  - Peters,NS
AU  - Barton,C
AU  - Cole,GD
AU  - Plymen,CM
DO  - 10.2196/45611
PY  - 2023///
SN  - 2561-1011
TI  - Smartphone-based remote monitoring in heart failure with reduced ejection fraction: retrospective cohort study of secondary care use and costs
T2  - JMIR Cardio
UR  - http://dx.doi.org/10.2196/45611
UR  - https://www.ncbi.nlm.nih.gov/pubmed/37351921
UR  - http://hdl.handle.net/10044/1/106147
VL  - 7
ER  -

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