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Trial question
What is the role of digital consultations in patients with HF?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
26.0% female
74.0% male
N = 150
150 patients (39 female, 111 male).
Inclusion criteria: patients diagnosed with HFrEF.
Key exclusion criteria: not in possession of any attributes to perform the consultations digitally.
Interventions
N=78 digital consultations (digital data sharing from patient to clinician, patient education via text-based e-learning, guideline recommendations to all treating clinicians).
N=72 usual care (standard of care according to the clinician and institution, left up to practice routines).
Primary outcome
Median improvement in guideline-directed medical therapy score over 12 weeks
1.19 points
0.08 points
1.2 points
0.9 points
0.6 points
0.3 points
0.0 points
Digital
consultations
Usual
care
Significant
increase ▲
Significantly greater improvement in median guideline-directed medical therapy score over 12 weeks (1.19 points vs. 0.08 points; AD 0.75 points, 95% CI 0.21 to 1.12).
Secondary outcomes
Significant increase in optimal medical therapy at 12 weeks (28.2% vs. 6.9%; AD 21.3%, 95% CI 5.09 to 37.51).
No significant difference in improvement in QoL at 12 weeks (2.8 AU vs. 2.1 AU; AD 0.7 AU, 95% CI -2.7 to 4.1).
No significant difference in amount of time investment for patients at 12 weeks (3 hours vs. 2.5 hours; AD 0.5 hours, 95% CI -1.26 to 2.26).
Conclusion
In patients diagnosed with HFrEF, digital consultations were superior to usual care with respect to median improvement in guideline-directed medical therapy score over 12 weeks.
Reference
Jelle P Man, Maarten A C Koole, Paola G Meregalli et al. Digital consults in heart failure care: a randomized controlled trial. Nat Med. 2024 Oct;30(10):2907-2913.
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