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The Association of Digital Health Application Use With Heart Failure Care and Outcomes: Insights From CONNECT-HF

Vishal N Rao1, Lisa A Kaltenbach2, Bradi B Granger3

  • 1Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC; Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, NC.

Journal of Cardiac Failure
|July 29, 2022
PubMed

Insights

Mobile health apps modestly improved heart failure (HF) quality scores and clinical outcomes in patients with heart failure with reduced ejection fraction (HFrEF). Further research is needed to confirm the benefits of digital tools for guideline-directed medical therapy (GDMT).

Area of Science:

  • Cardiology
  • Digital Health
  • Health Services Research

Background:

  • The impact of digital applications on guideline-directed medical therapy (GDMT) and outcomes for heart failure with reduced ejection fraction (HFrEF) remains unclear.
  • Assessing the efficacy of mobile health applications in improving care and outcomes for HFrEF patients is crucial.

Purpose of the Study:

  • To investigate whether digital applications can enhance GDMT and improve clinical outcomes in patients hospitalized with HFrEF.
  • To evaluate the association between mobile health application use and quality of care scores in HFrEF patients.

Main Methods:

  • An ancillary study of the CONNECT-HF trial prospectively evaluated a mobile health application among HFrEF patients.
  • Digital users were matched to nonusers from the usual-care group.
  • Coprimary outcomes included changes in composite HF quality scores and HF rehospitalization or all-cause mortality.

Main Results:

  • Out of 2431 patients offered digital applications, 17% used them, 63% had limited access or data, and 20% declined.
  • Digital users (n=368) showed improved composite HF quality scores (48.0% vs 43.6%; P=0.001) compared to matched nonusers (n=368).
  • Digital users also experienced better composite clinical outcomes (33.0% vs 39.6%; HR 0.76; P=0.027) than nonusers.

Conclusions:

  • Modest use of digital applications in the CONNECT-HF trial was linked to higher HF quality-of-care scores and improved clinical outcomes.
  • The findings suggest that technology-guided GDMT use and dosing in HFrEF warrants further investigation, despite the study's observational nature.
Abstract

Keywords:
Heart failureclinical trialsimplementation sciencemobile healthquality improvement

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