Remote non-invasive ICT monitoring for heart failure: a feasibility study
摘要
As Japan becomes an aging society, the number of patients with heart failure (HF) is increasing. The European Society of Cardiology guidelines recommend noninvasive ICT monitoring from the perspective of self-care and team medical care; however, evidence regarding the effectiveness of remote monitoring in Japan is limited. This study assessed the usefulness of OMRON Connect with the Health Data Monitoring System, which provides simultaneous sharing of biomonitoring data of patients with HF using wireless devices. A prospective, single-arm, multicenter observational study for 84 days was performed, including 30 patients with HF (age 72 ± 5.6 years, male, n = 19). They were introduced to the measurement of body weight (BW), blood pressure (BP), electrocardiogram (ECG) recording, and patient-reported symptoms on a smartphone application (PRS on App) using OMRON Connect. The primary outcome was adherence to this system, and the secondary outcome included factors that influence adherence. The adherence measurements were as follows: BW, 97.0% (interquartile range [IQR] 92.3–100%); BP, 88.7% (IQR, 79.8–95.8%); and ECG, 88.7% (IQR, 64.9–94.1%). No patients dropped out during the 84-day period. No significant relationship was found between adherence and the following parameters: age, sex, prior HF admission, left ventricular ejection fraction, New York Heart Association class, serum brain natriuretic peptide level, renal function, cognitive impairment, and living alone or with family. However, the continuation rate of PRS on App gradually decreased to 53%. One of the patients was admitted for HF exacerbation, and this system could clearly detect BW increase before admission. In addition, fatal arrhythmias, such as a short run of premature ventricular contractions or advanced atrioventricular block, could be detected in ECG. The use of OMRON Connect for noninvasive ICT monitoring in patients with HF demonstrates good adherence in checking BP, BW change, and ECG changes. This method proves to be feasible for patient self-management and facilitates appropriate clinical intervention.