Heart failure & cardiomyopathiesRandomised controlled trial
The Effect of Using a Remote Patient Management Platform in Optimizing Guideline-Directed Medical Therapy in Heart Failure Patients
- Randomised controlled trial
- open-label
Authors' conclusion
Remote titration of GDMT in heart failure with reduced ejection fraction was effective, safe, feasible, and increased the proportion of patients achieving target doses, in a shorter period of time with no excess adverse events compared with UC.
Study context
- Population
- Patients with HFrEF
- Participants
- 108 patients
- Comparison
- Remote guideline-directed medical therapy (GDMT) titration vs usual care
- Medlyn = 56
- Usual care (UC)n = 52reference
- Primary endpoint
- Proportion of patients completing GDMT titration
- Follow-up
- 6 months
Primary result
As reported in the abstract
GDMT titration completed
P = 0.001
Secondary outcomes
| Outcome | IRR (95% CI) | P value | |
|---|---|---|---|
| Urgent clinic/ED visits · similar between groups | 0.90 (0.53–1.56) | P = 0.70 | |
| All-cause hospitalization · reduction with remote titration | 0.55 (0.31–0.97) | P = 0.042 | |
| 0.20.5125Incidence rate ratio (log scale) |
| Outcome | Estimate | P value |
|---|---|---|
| In-person clinic visits to complete titration | P = 0.004 | |
| Virtual clinic visits to complete titration | P = 0.009 | |
| Time to optimization | P < 0.001 |
- In-person clinic visits to complete titration: remote titration 1.62 ± 1.09 vs 2.42 ± 1.65 (mean ± SD); fewer with remote titration
- Virtual clinic visits to complete titration: remote titration 0.50 ± 1.08 vs 1.29 ± 1.86 (mean ± SD); fewer with remote titration
- Time to optimization: median 3.42 months [Q1-Q3: 2.99-4.04] with remote titration vs 5.47 months [Q1-Q3: 4.14-7.33]; shorter with remote titration
Original publication
The Effect of Using a Remote Patient Management Platform in Optimizing Guideline-Directed Medical Therapy in Heart Failure Patients. JACC Heart Fail. doi:10.1016/j.jchf.2024.02.008
Summarised from the published abstract; every number is checked against it