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Remote Monitoring Program Cuts Heart Failure Readmissions In Half
A remote monitoring program launched by UMass Memorial Health–Harrington led to a 50% reduction in 30-day readmissions for patients with congestive heart failure, according to a news release.1
The program utilizes Brook Health's artificial intelligence (AI)–powered platform, combining AI with human care teams to monitor patients remotely, helping to reduce unnecessary hospitalizations and improve patient outcomes.
The program equips patients with internet-connected scales and blood pressure cuffsImage credit: Photo Sesaon – stock.Adobe.Com
Through the program, patients are equipped with internet-connected scales and blood pressure cuffs, allowing them to track their weight and blood pressure from home. Data from these devices are automatically sent to the Brook Health app, where nurses monitor patient information in real time. The care teams are then able to intervene early, providing education, troubleshooting, and care coordination.
According to Oren Nissim, CEO and cofounder of Brook Health, this approach empowers care teams to provide more personal care for congestive heart failure while breaking through the location barrier.
"This forward-thinking approach demonstrates how technology and human expertise can combine to extend the reach of healthcare teams, ensuring patients receive timely, personalized care even when resources are stretched," Nissim said. "The success at Harrington is a testament to what's possible when innovative healthcare leaders embrace new models of care delivery."
It's important to note that no accompanying study was made available to verify the findings at the time of publication.
The remote monitoring program at UMass Memorial Health is part of a broader push to implement similar programs for other chronic conditions, including chronic obstructive pulmonary disease (COPD), diabetes, and hypertension. By enabling patients to track their health data from home, these programs aim to reduce hospitalizations and improve the long-term management of chronic diseases. This digital health initiative helps bridge the gap in health care access, particularly as health systems continue to face staffing shortages.
Remote patient monitoring has proven to be a powerful tool in managing chronic diseases. Preliminary research presented at the American Heart Association's Hypertension Scientific Sessions 2024 showed that 74% of patients with resistant high blood pressure were able to gain control of their condition within 12 months by using a different Bluetooth-enabled monitoring system, combined with regular pharmacist interactions.2 The program significantly reduced hospitalizations and improved medication adherence by allowing health care providers to monitor patients' blood pressure in real time and adjust treatment as needed.
Another study on remote monitoring for systolic heart failure found that integrating wearable cardioverter-defibrillators and virtual nurse consultations significantly improved patient outcomes.3 In the study, presented at the Heart Failure Society of America Annual Scientific Meeting, patients with newly-diagnosed systolic heart failure were able to receive regular care without frequent in-person visits, allowing for real-time monitoring and medication adjustments. After 12 weeks, many patients showed improvements in their systolic function, demonstrating the effectiveness of combining telemedicine with remote physiological monitoring, particularly for those in remote or underserved areas.
Collectively, these findings further underscore the growing role of remote monitoring in improving patient outcomes for chronic conditions. As health care systems continue to adopt these technologies, the integration of AI and real-time data monitoring could change the management of diseases like heart failure and hypertension.
References
Mediterranean Diet Can Help Lower Heart Failure Risk, Particularly In Women
New research confirms Mediterranean diet's protective effect on heart health. Image credit: Ina Peters/Stocksy.Heart failure is a major health issue associated with mortality and high healthcare costs.
Overall heart failure prevalence is growing around the world, currently affecting 1% to 3% of the population.
European researchers have found that adhering to the Mediterranean diet may help lower heart failure risk, especially for women.
Women may have distinct risks for heart failure that following a Mediterranean diet could help lower.
Heart failure, also known as systolic congestive heart failure, occurs when the heart muscle becomes weak and cannot circulate blood as it should. Heart failure does not mean that the heart stops beating, but it is a serious, long-term condition that requires medical attention.
To date, a heart transplant is the only known cure for heart failure. People may be able to manage this condition with medications, medical procedures, or lifestyle adjustments.
Some researchers estimate that, globally, 64 million people have heart failure. In the United States, around 6.7 million adults over the age of 20 years live with heart failure, and experts expect that an estimated 8.7 million people in the U.S. Will have it by 2030.
This condition's incidence appears to be on the rise due to aging, genetic predisposition, and lifestyle factors. Further risk factors include ischemic heart disease, obesity, hypertension (high blood pressure), diabetes, and smoking.
A 2023 Journal of Cardiac Failure article reported that heart failure cases are increasing more among women compared to men.
A group of European scientists believe that interventions aimed at heart failure prevention may help lower heart failure incidence while improving survival and hospitalization rates. They reviewed 682 publications that linked the Mediterranean diet with lower heart failure risk.
The researchers observed evidence that Mediterranean diet adherence was associated with a markedly reduced risk of heart failure. This effect was especially evident in women.
Their findings appear in the European Journal of Clinical Nutrition.
Mediterranean diet linked to lower heart failure risk in womenThis review results was conducted by a team of experts from the University of Palermo, the Kore University of Enna, and the CNR Neuroscience Institute, all in Italy, in collaboration with colleagues from King's College London, Anglia Ruskin University, and the University of Liverpool, in the United Kingdom.
The researchers originally searched through 682 prospective or retrospective cohort studies. They assessed data on adults aged 18 years and over without a history of heart failure at the baseline.
After eliminating publications due to duplication and other exclusion criteria, the team focused on six prospective studies that included 216,385 subjects living in Europe. Women made up 54.7% of the studied population.
The team transformed the varied scales of diet adherence used in the six studies into Mediterranean diet scores ranging from 0 to 9. They calculated the association between an increase in one point and heart failure risk.
After an average of 11 years of follow-up, 6,978 people developed heart failure. This amounted to 3% of the initial population in all the six studies analyzed.
Furthermore, the authors reported that an increase in one point in the Mediterranean diet score correlated with a "significantly lower risk of heart failure."
Upon analyzing the association between adherence to the Mediterranean diet and heart failure incidence in men and women, the scientists said that "a positive association was observed in women."
However, the association was not "statistically significant" in men.
What makes the Mediterranean diet heart-healthy?Mediterranean diet refers to the traditional dietary eating patterns of people living along the Mediterranean coast. In its earliest days, the regimen was mostly vegetarian. Over 20 countries surround the Mediterranean Sea, so the exact foods used can differ in various places.
Wherever people follow the Mediterranean diet, they tend to incorporate high amounts of fresh foods, especially vegetables and fruits, as well as fish.
Medical News Today discussed the findings of the review with Ernst von Schwarz, MD, PhD, FESC, FACC, FSCAI, who is a clinical and academic professor of medicine at UCLA and UC Riverside.
Von Schwarz, who was not involved in this review, told us that "it's [been] well known [for] many years that the heart-healthiest diet is the Mediterranean-type diet, especially because of the healthier fat intake."
The "healthier fats" in question are monounsaturated fats, such as those found in olive oil, and polyunsaturated fats derived from fish and nuts.
The review authors also offered potential explanations for the Mediterranean diet's protective effect against heart failure.
Firstly, they wrote, "the Mediterranean diet exhibits anti-inflammatory and antioxidant effects that could lower inflammation, oxidative stress, and endothelial dysfunction, which are the underlying complications leading to atherosclerosis, [cardiovascular diseases], and [heart failure]."
The diet may help lower lipids (fats) and protect against oxidative stress. It might also "reduce levels of heart failure biomarkers."
Michelle Routhenstein, MS, RD, CDCES, CDN, a preventive cardiology dietitian at EntirelyNourished, who was not involved in the review explained that:
"The Mediterranean diet may have a stronger impact on women because it addresses their specific nutritional needs, potentially helping to manage insulin resistance and inflammation, which can aid in slowing the progression of heart failure."
What does heart failure look like in women?Von Schwarz shared that heart failure symptoms in women are often "atypical or nonspecific." He noted that there is often "a delay in the appropriate diagnostic steps, so conditions like a heart attack, unstable angina, or even heart failure are often diagnosed too late [in women]."
He added that heart failure in women tends to result more often because of uncontrolled hypertension, which leads to hypertensive heart disease. He also mentioned that diabetes is another major risk factor for heart failure.
According to Routhenstein, "women may be more susceptible to heart failure due to hormonal differences, different heart sizes and different patterns of heart remodeling."
She also said that many risk factors may go unnoticed in women, which can increase heart failure risk as well. Pregnancy-related conditions, such as gestational hypertension or preeclampsia may also contribute to heart failure, noted Routhenstein.
Bradley Serwer, MD, an interventional cardiologist and chief medical officer at VitalSolution, who was also not involved in the present review, further explained how hormonal risk factors can arise due to menopause.
"Native estrogen has a significant protective effect [and] postmenopausal women have a high risk [of heart problems] due to declining levels of estrogen," he pointed out.
He also mentioned pregnancy and postpartum-related risk factors, noting that "peripartum cardiomyopathy can be seen in women who have recently been pregnant."
What are the limitations of this review?The review authors concluded that their "meta-analysis confirms the important role of following the Mediterranean diet in preventing [cardiovascular disease]."
However, they also acknowledged that their work was subject to several limitations.
Their meta-analysis only reviewed six observational studies, few in number and susceptible to bias. Serwer noted that the review "does not show causality — only a correlation, and there is no proposed mechanism of action."
Moreover, the six studies were all conducted in European countries. This makes the results difficult to generalize across all populations.
Furthermore, the Mediterranean diet in other European regions may be different than in the Mediterranean region, as lifestyles, climate, and food production likely vary.
Then, there is the issue that the studies analyzed covered the period between 1994 and 2013. Other recent research suggests that Mediterranean diet adherence is declining, which could have rendered different results.
Finally, several studies did not account for changes in Mediterranean diet adherence during follow-up, either.
Expert tips to protect heart healthMNT asked our experts when the best time is to get tested for heart failure.
Routhenstein emphasized that "heart failure has many stages and often there are no symptoms until the later stages."
"I would recommend testing for heart failure in those with risk factors like a high lipoprotein(a), strong family history of heart disease or high blood pressure, diabetes, or heart disease," she advised.
Serwer added that: "Heart failure is a clinical diagnosis which is […] based on symptoms and an examination. Anyone who has worsening shortness of breath, difficulty breathing while laying down, swelling of legs or significant fluid retention should be screened by trained medical professionals."
He also recommended screening for people with a family history of cardiomyopathy, even if asymptomatic.
Finally, von Schwarz also advised cardiac examination in cases of "shortness of breath with little activity, especially if it's a new onset. The most common symptom among more women than men is fatigue."
He emphasized that age does not matter: Even people in their 20s may be vulnerable to heart failure.
View the original article on Medical News Today
Research Explores Integration Of Remote Monitoring For HF, Heart Transplant Allocation Impact
Research presented at HFSA showed investigations of remote physiological monitoring for systolic heart failure and the new heart transplant allocation system in urban and rural communities.
Image Credit: eggeeggjiew - stock.Adobe.Com
Among the posters released as part of the Heart Failure Society of America (HFSA) Annual Scientific Meeting, one examined the integration of remote physiological monitoring telemedicine clinics for treating systolic heart failure (HF),1 and another explored the impact of a new heart transplant (HT) allocation system on urban and rural communities.2 The HFSA meeting was planned for September in Atlanta, Georgia, but was canceled due to Hurricane Helene.
Remote Monitoring for Systolic Heart FailureA new approach allowing patients to receive regular care without the need for frequent in-person visits showed potential to improve treatment adherence and outcomes.1 Managing newly diagnosed systolic HF requires close monitoring and frequent medication adjustments, which can be challenging for patients living far from health care facilities. The study aimed to address these challenges by integrating remote physiological monitoring into a telemedicine clinic led by a nurse practitioner.
Patients with newly diagnosed systolic HF and a left ventricular ejection fraction (LVEF) of less than 35% were provided with wearable cardioverter-defibrillators (WCDs) and enrolled in a telemedicine program. They had weekly virtual visits with a nurse practitioner certified in HF who monitored their condition, adjusted medications, and facilitated further diagnostic workups, such as catheterizations or advanced imaging. The WCD provided real-time physiological data to support these clinical decisions.
At the end of the 12-week program, patients underwent repeat echocardiograms, and many showed improvements in their systolic function. These results demonstrated that the combination of remote monitoring and telemedicine was an effective and safe strategy for treating systolic HF, especially in patients spread across large geographic areas. The study's findings support the expansion of telemedicine programs with remote physiological monitoring to provide comprehensive care to patients with HF who may otherwise face barriers to consistent treatment.
Disparities in Heart Transplant AllocationThe second study addressed the potential inequities that have emerged following the implementation of a new heart transplant allocation system in 2018.2 This system, which aimed to prioritize the sickest patients, has led to changes in waitlist times, transplant rates, and the geographic distribution of organs. Despite the improvements brought by system change, the researchers decided to examine whether these changes had differing effects on patients based on whether they lived in urban or rural areas.
The study included adult patients listed for HT in United Network for Organ Sharing data and transplant statistics from January 2014 through December 2021. It compared outcomes under the old and new allocation systems, excluding patients who had undergone retransplantation or multi-organ transplantation.
Although there were no significant differences in death/delisting rates or transplant rates between rural and urban residents under the old system, disparities emerged under the new system. Rural residents had a higher cumulative incidence of death or delisting from the waitlist and a higher rate of transplantation (HR, 1.29; 95% Cl, 1.06-1.57; P = .01). Additionally, the cumulative incidence of transplantation was higher among rural residents (HR, 1.09; 95% Cl, 1.02-1.17; P = .011). However, posttransplant survival rates remained similar across both rural and urban groups under both systems.
These findings suggest that rural patients face a higher risk of not receiving a transplant, possibly due to differences in health care access and delivery. Although the new system may have improved outcomes for some, the study highlights the need for further investigation into these disparities.
The Efforts to Address Barriers to Care ContinuesThese HFSA posters shed light on important areas of research as health care practices and systems evolve. The integration of remote physiological monitoring in telemedicine clinics shows promise for improving care for patients with systolic HF, especially in underserved areas. At the same time, the new heart transplant allocation system may have inadvertently increased geographic disparities, particularly for rural patients.
References
1. Desiderio D, Glunk D, Desiderio M. In rural communities, augmenting telemedicine with remote monitoring enhances heart failure management: proof of concept. Prepared for: HFSA 2024; September 27-30, 2024 (cancelled); Atlanta, Georgia. Poster.
2. Ahmed MU, Marsy D, Fermin D, et al. Disparities in heart transplant waitlist outcomes in rural communities in the current UNOS allocation system. Prepared for: HFSA 2024; September 27-30, 2024 (cancelled); Atlanta, Georgia. Poster.
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