A Digital Platform to Optimize Guideline-Directed Heart Failure Therapy: Rationale and Design of the AIM-POWER Trial

Area of Science:

• Cardiology
• Digital Health
• Pharmacology

Background:

• Heart failure (HF) patients face high hospitalization and mortality risks, partly due to underutilization of guideline-directed medical therapy.
• Digital interventions offer potential for timely initiation and titration of HF therapies, but require rigorous evaluation.
• The AIM-POWER study investigated a digital therapeutic (DTx) for HF management.

Purpose of the Study:

• To evaluate the safety and efficacy of the BiovitalsHF DTx platform.
• To assess the platform's ability to guide optimal initiation and titration of pharmacological therapy in HFrEF patients.
• To determine if digital support improves adherence to HF treatment guidelines.

Main Methods:

• 122 symptomatic HFrEF patients (LVEF ≤ 40%) not optimized on HF therapy were enrolled.
• Participants were randomized 1:1 to BiovitalsHF-supported care or usual care in an open-label manner.
• BiovitalsHF utilized wearable monitors and digital scales to provide therapy recommendations to clinicians.

Main Results:

• The primary outcome was the change in the HF optimal medical therapy score from baseline to 90 days.
• Data on patient status and therapy recommendations were collected via the BiovitalsHF platform.
• Clinician decisions on prescribing and titration were independent of the platform's suggestions.

Conclusions:

• The AIM-POWER study provides insights into digital interventions for HF management.
• The effectiveness of BiovitalsHF in improving pharmacological therapy use and dosing for HFrEF patients was evaluated.
• Results will inform the broader application of digital health strategies in cardiovascular care.