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An ongoing study at MedStar Health Research Institute seeks to determine whether an app-based solution can help patients with heart failure stay on the proper dosage of lifesaving medications.
Heart failure is a devastating condition with significant human and economic costs. About 6.2 million adults in the U.S. have heart failure, accounting for 13.4% of deaths in 2018 and $30 billion in healthcare expenditures annually.
Heart failure with reduced ejection fraction (HFreEF, or systolic heart failure, occurs when the left side of the heart doesn’t pump blood through the body as well as it should. About half of U.S. patients with heart failure have HFrEF—treatment for it involves four types of medication:—treatment for it involves four classes of medicine:
- ACE inhibitors / ARBs / ARNI
- Beta-blockers
- MRAs
- SGLT2 inhibitors
For optimal benefit with fewer side effects, the dosage of each drug must be continually adjusted to target dosages used in the clinical trials of these medications. And for many patients, there are many challenges or barriers to taking them as directed.
For example, medication adjustments often require patients to visit the clinic every two to four weeks so providers can check their vital signs. Lack of transportation, economic concerns, and other social determinants of health may be part of why patients tend to fill fewer prescriptions as time goes on and eventually fall through the cracks.
Without the proper use of medications, some patients face hospitalization or death. It’s clear we need a better solution—and that’s where our research with the BiovitalsHF platform by Biofourmis comes in.
We are enrolling patients in the “Artificial Intelligence Mobile Health Trial of a Digital Platform to Optimize GDMT Using Wearable Sensors” (AIM-POWER) to determine whether app-based, at-home vital sign monitoring can help streamline medication adjustments, identify barriers to care and stay on track with their care plan.
Cloud-based vital signs monitoring.
Providers at MedStar Washington Hospital Center and MedStar Union Memorial Hospital are enrolling patients in our randomized AIM-POWER clinical trial, which studies the Biovitals platform. This platform combines a smartphone app and sensors that measure a patient’s blood pressure, pulse rate, and respiratory rate at home.
Once a measurement is recorded, the platform uploads the data to a cloud server, where an algorithm crunches the numbers and alerts the doctor if a medication adjustment is needed. Then, providers review the data and call the patient to discuss their medication.
Along with my other co-Principal Investigators, Ajay Kadakkal, MD, and Richa Gupta, MD, MPH, we’re working to determine whether this device can help patients optimize their medication therapy over 90 days compared to the standard treatment.
How the app might help save lives.
There are several benefits to this app-based solution. Similar to standard smartphone notifications, the Biovitals platform will remind patients and providers that consistent monitoring of vital signs and medication titration produces the best results.
The platform also provides patient education through regular calls with the doctor, allowing patients to ask questions about their condition and giving providers a chance to reinforce the importance of compliance.
While seeing patients in person helps deepen patient-provider relationships, the Biovitals platform has the potential to reduce the need for frequent clinic visits while optimizing patient care.
By helping patients achieve and adhere to target doses, seemingly simple technological improvements can profoundly impact by reducing hospitalizations and saving lives.
