Heart failure affects 5.8 million people in the U.S. alone and is responsible for nearly 1 million hospitalizations each year, most resulting from a build-up of body fluid in the lungs and other organs due to the heart's inability to pump effectively. The disease needs to be closely tracked in order to avoid such hospitalizations, and home-monitoring interventions may be especially useful, UCLA researchers say.
In their new paper, the UCLA authors discuss the importance of heart failure disease-management and early identification, as well as the treatment of body-fluid congestion, using a number of home-monitoring strategies, including self-care, such as daily weighing and medication management; phone calls from a nurse or automated response system; home health visits; and telemedicine and remote monitoring with implantable and external devices to track vital information.
The field of heart failure home-monitoring is fairly new. Further study will help assess optimal approaches, such as identifying which patients may benefit the most from such monitoring, and will determine which health data -- blood pressure or shortness of breath, for example -- may be the best to monitor. Promising new technologies, including devices to track heart-ventricle and pulmonary artery pressures, which are closely related to congestion development and clinical outcomes, may be particularly promising.
The authors suggest that the best approach is most likely multi-pronged, including monitoring along with patient follow-up and feedback.
UCLA is currently running Better Effectiveness After Transition-Heart Failure (BEAT-HF), a multicenter trial testing enhanced transitions of care and telemonitoring for patients recently hospitalized with heart failure.
Dr. Gregg C. Fonarow, UCLA's Eliot Corday Professor of Cardiovascular Medicine and Science, director of the Ahmanson-UCLA Cardiomyopathy Center, and co-chief of clinical cardiology at the David Geffen School of Medicine at UCLA, is available for interviews.
The Ahmanson Foundation and the Agency for Healthcare Research and Quality funded the research. Fonarow has served as a consultant for Medtronic.
The research appears in the Jan. 10 issue of the Journal of the American College of Cardiology. A copy of the full study is available.