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Published on: April 19, 2019
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Remote Management of Patients With Heart Failure in Medically Underserved Areas
Jeremy Florence1, Sylvain Ploux2, Clément Riocreux3
1Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France; MIRACL.ai laboratory, Multimodality Imaging for Research and Analysis Core Laboratory and Artificial Intelligence, University Hospital of Lariboisière (AP-HP), Paris, France.
JACC. Advances
|March 21, 2026
Summary
Structured remote management (RM) programs benefit heart failure (HF) patients equally, regardless of whether they live in medically underserved areas (MUAs). This study found no significant difference in outcomes for HF patients in MUAs compared to non-MUAs.
Area of Science:
- Cardiology
- Health Services Research
- Digital Health
Background:
- Medically underserved areas (MUAs) are linked to increased hospitalizations and mortality.
- Structured remote management (RM) programs show clinical benefits, but their impact in European MUAs is understudied.
Purpose of the Study:
- To evaluate if heart failure (HF) patients achieve similar outcomes from a structured, multiparametric RM program, irrespective of MUA status.
- To compare the effectiveness of RM in patients residing in MUAs versus non-MUAs.
Main Methods:
- A cohort of 1,040 HF patients were enrolled in a standardized RM program across two French regions from April 2020 to December 2022.
- Inclusion criteria included chronic HF with recent hospitalization or advanced symptoms (NYHA class ≥II) and elevated biomarkers.
- Remote assessments included weight, blood pressure, heart rate, symptoms, biology, and device data. The primary outcome was a composite of unplanned HF hospitalization or all-cause mortality.
Main Results:
- 32% of patients lived in MUAs. The primary outcome occurred at an annualized rate of 13.7% overall.
- No significant difference in the primary outcome rate was observed between MUA (13.5%) and non-MUA (13.9%) patients (P = 0.876).
- MUAs were not independently associated with the primary outcome (adjusted HR: 0.93; P = 0.84), and survival curves did not differ between groups (P = 0.83).
Conclusions:
- Structured, multiparametric RM programs provide comparable outcomes for heart failure patients, regardless of their residence in medically underserved areas.
- RM is an effective strategy for managing HF patients in diverse geographical settings, including MUAs.
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