Tailoring remote patient management to optimise cardiovascular risk management in primary care: a mixed-methods...

Area of Science:

• Cardiovascular Medicine
• Health Services Research
• Digital Health

Background:

• Remote patient management (RPM) is vital for cardiovascular risk management but faces implementation hurdles.
• Panel management, utilizing comprehensive data, can identify at-risk patients and personalize interventions for better cardiovascular disease (CVD) management.

Purpose of the Study:

• To evaluate the implementation strategies and clinical outcomes of a multi-component RPM intervention called 'Connect@Heart'.
• To assess the feasibility and effectiveness of tailored RPM interventions for cardiovascular risk management in primary care settings.

Main Methods:

• A six-month mixed-methods study in four Dutch primary care practices.
• Two patient groups: BMI < 25 (BP Box) and BMI > 25 or CVD (Lifestyle Box) with tailored devices.
• Linear mixed-effects models for clinical outcomes and RE-AIM framework for implementation evaluation.

Main Results:

• High enrolment rate (94%) with 189 participants.
• Significant blood pressure reduction in both groups (e.g., systolic BP decreased in Lifestyle Box group from 142±16 to 131±14 mmHg, p<0.001).
• Sustained patient engagement (66% weekly measurements) and continued practice adoption post-study.

Conclusions:

• Proactive identification of at-risk patient panels and tailored RPM interventions are effective implementation strategies.
• This approach shows promise for achieving favorable clinical outcomes at scale in cardiovascular disease management.