Remote digital intervention targeting heart failure medical therapy: a randomized controlled trial

Area of Science:

• Cardiology
• Digital Health
• Clinical Trials

Background:

• Heart failure (HF) is a major cause of morbidity and mortality, often due to underuse of evidence-based pharmacotherapies.
• Remote digital platforms offer potential to improve medication initiation and titration for HF patients outside of clinic visits.
• The efficacy and safety of such digital interventions require rigorous testing in randomized trials.

Purpose of the Study:

• To assess the impact of a remote, digital intervention on the use and titration of evidence-based therapies for heart failure (HF).
• To evaluate the safety and effectiveness of the VITAL-HF digital intervention in patients with HF with reduced ejection fraction (HFrEF).

Main Methods:

• VITAL-HF was a multicenter, randomized controlled trial involving adults with HFrEF not optimized on HF therapy.
• Participants received either a digital intervention or usual care, both groups using connected scales and blood pressure cuffs for daily vital sign monitoring.
• The primary outcome was the change in a HF medical therapy score, with follow-up at 3 and 6 months.

Main Results:

• The digital intervention group showed a greater increase in the HF medical therapy score compared to the usual care group (mean difference 0.78, p=0.007).
• At six months, the mean score increased by 2.0 points in the intervention group versus 1.4 points in the usual care group.
• The intervention was associated with a low number of safety events, comparable to usual care.

Conclusions:

• Remote digital interventions are safe and effective for improving HF medical therapy scores in HFrEF patients.
• This approach facilitates optimization of evidence-based treatments, enhancing patient care beyond traditional clinical settings.