Home-based telemonitoring care and executive function in patients with heart failure

Area of Science:

• Cardiology
• Gerontology
• Health Informatics

Background:

• Self-care ability is crucial for managing heart failure (HF).
• Executive function significantly impacts self-care in HF patients.
• Home-based remote care programs offer a novel approach to patient management.

Purpose of the Study:

• To investigate the effect of a telemonitoring and telecoaching program on executive function in HF patients.
• To assess the relationship between executive function and clinical outcomes, including HF hospitalization and mortality.
• To evaluate the clinical influence of enhanced self-care abilities through remote interventions.

Main Methods:

• Prospective study involving outpatients with HF participating in a home-based remote care program.
• Intervention included telemonitoring and telecoaching using self-measured physical data.
• Executive function assessed via Trail Making Test Part B (TMT-B); clinical outcomes compared based on baseline executive function.

Main Results:

• The remote care program significantly improved TMT-B scores (p=0.039) and ameliorated HF symptoms (NYHA class, p=0.027) after 12 months.
• Patients with executive dysfunction at baseline had a significantly higher incidence of HF hospitalization (HR: 4.97, p=0.031).
• The association between executive dysfunction and hospitalization remained significant even in a subcohort without general cognitive dysfunction.

Conclusions:

• Home-based telemonitoring and telecoaching may effectively enhance executive function in heart failure patients.
• Executive function status is linked to clinical outcomes, specifically HF hospitalization risk.
• Further research is warranted to confirm if supportive care targeting executive functioning improves HF patient outcomes.