CATEGORY: eHealth, Health monitoring, e-Health applications, Cardiovascular diseases, Virtual Assistant, Remote patient monitoring
SOURCE: Int. J. Environ. Res. Public Health 2023, FEB. 22, 20(5), 3937; https://doi.org/10.3390/ijerph20053937;

Assessing the Efficacy of a Virtual Assistant in the Remote Cardiac Rehabilitation of Heart Failure and Ischemic Heart Disease Patients: Case-Control Study of Romanian Adult Patients

Andreea Lăcraru, Ștefan-Sebastian Busnatu, Maria-Alexandra Pană, Gabriel Olteanu, Liviu Șerbănoiu, Kai Gand, Hannes Schlieter, Sofoklis Kyriazakos, Octavian Ceban, Cătălina Liliana Andrei & Crina-Julieta Sinescu

Abstract

Cardiovascular diseases (CVDs) are the leading cause of mortality in Europe, with potentially more than 60 million deaths per year, with an age-standardized rate of morbidity-mortality higher in men than women, exceeding deaths from cancer. Heart attacks and strokes account for more than four out of every five CVD fatalities globally. After a patient overcomes an acute cardiovascular event, they are referred for rehabilitation to help them to restore most of their normal cardiac functions. One effective way to provide this activity regimen is via virtual models or telerehabilitation, where the patient can avail themselves of the rehabilitation services from the comfort of their homes at designated timings. Under the funding of the European Union’s Horizon 2020 Research and Innovation program, grant no 769807, a virtual rehabilitation assistant has been designed for elderly patients (vCare), with the overall objective of supporting recovery and an active life at home, enhancing patients’ quality of life, lowering disease-specific risk factors, and ensuring better adherence to a home rehabilitation program. In the vCare project, the Carol Davila University of Bucharest (UMFCD) was in charge of the heart failure (HF) and ischemic heart disease (IHD) groups of patients. By creating a digital environment at patients’ homes, the vCare system’s effectiveness, use, and feasibility was evaluated. A total of 30 heart failure patients and 20 ischemic heart disease patients were included in the study. Despite the COVID-19 restrictions and a few technical difficulties, HF and IHD patients who performed cardiac rehabilitation using the vCare system had similar results compared to the ambulatory group, and better results compared to the control group.

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Study Description

AZIMUTH model of care is delivered through Healthentia; a Software as a Service (SaaS) medical device via a mobile application for patients and a clinical dashboard for clinicians for Remote Patient Monitoring (RPM), Patient Support Programs (PSP) and Digital Therapeutics (DTx). This innovative scalable model of personalised remote heart failure care is based on good clinical practice standards and international guidelines for heart failure management and has been designed taking into consideration both the optimization of in-hospital care delivery models as well as the often unmonitored out-of-hospital and home settings

The first phase of the study has successfully validated the feasibility, patient acceptance and perceived value of the app-based model of care, demonstrating increased user engagement in patients that leads into improved adherence to treatment.

Dr. Domenico D’Amario

Senior Cardiologist at the Gemelli IRCCS Polyclinic Foundation

Study Details

• Type:  Interventional
• Disease:  Heart Failure – Chronic Ischemic Disease
• Sites: Fondazione Policlinico Gemelli
• Start:  Phase 1: Nov-March 2021, Phase 2: Jul-Jan 2023
• Population: 300 patients
• Duration: Multiphase project

Study Design & Method

Heart failure is the leading cause of death and hospitalisation in patients aged > 65 years and a major and growing medical and economic burden, with high prevalence and incidence rates worldwide. The recent pandemic crisis has made even more evident, some critical aspects in the management of complex chronic diseases, such as heart failure, and these could be exacerbated by the increased demand for care in the future. Therefore, a significant effort must be made to align services with patients’ care needs by identifying a shared model that can exploit the most advanced technologies to enhance disease deterioration, provide adequate integration between hospital and territorial services, increase appropriateness, and reduce waiting times for specialist services.

Testimonial

The care pathway for patients with heart failure includes several steps, from acute phase treatments to chronic phase patient follow-up. This requires a close dialogue between hospital cardiologists and community medicine, especially once the patient returns home, after being discharged from a third-level hospital. But at the moment this complex path is very fragmented.

Validated the feasibility, patient acceptance and perceived value of remote patient monitoring

Demonstrating increased user engagement in patients that leads into improved adherence to treatment

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