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ObjectivesSUPPORT-HF 2 tests the hypothesis that home monitoring with information technology-supported specialist management is more effective in optimizing medical therapy than is home monitoring alone for patients with heart failure.Methods and resultsThe study was designed as a 2-armed partially blinded parallel randomized controlled trial. Seven sites in the United Kingdom (UK) recruited a total of 202 adults with heart failure at high risk of adverse outcomes and with potential to benefit from remote management (mean age 73 years, 28% female, median left ventricular ejection fraction 37%). Both arms are given a home monitoring and communication kit (Internet-enabled tablet computer, Bluetooth-enabled blood pressure and heart rate monitor, and weighing scale). For each participant, an individualized plan for treatment of heart failure and major comorbidities is developed before randomization. Participants randomized to intervention receive regular feedback to support self-management, and their physicians receive advice on blood investigations and pharmacological treatment from a central specialist heart failure team. Participants in the control arm use the same monitoring system but with no central medical management support. The primary outcome is the use of recommended medical therapy, defined as treatment consistent with the guidelines for management of patients with chronic heart failure, and will be measured as a composite opportunity score. The trial data collection ended in October 2017, and results will be reported in 2019.Trial registrationISRCTN86212709.ConclusionsPreliminary experience suggests that central provision of tailored specialist management using commercially available low-cost monitoring and computing devices, enhanced by customized applications, is feasible.

Original publication

DOI

10.1016/j.ahj.2018.09.007

Type

Journal article

Journal

American heart journal

Publication Date

02/2019

Volume

208

Pages

55 - 64

Addresses

The George Institute for Global Health, University of Oxford, 1st Floor, Hayes House, 75 George St, Oxford, United Kingdom.

Keywords

SUPPORT-HF 2 Investigators and Committees. Electronic address: kazem.rahimi@georgeinstitute.ox.ac.uk, Humans, Blood Pressure Determination, Stroke Volume, Telemetry, Treatment Outcome, Self Care, Feasibility Studies, Telemedicine, Heart Rate, Ventricular Function, Left, Patient Selection, Internet, Computers, Handheld, User-Computer Interface, Decision Support Systems, Clinical, Aged, Patient Dropouts, Home Care Services, Female, Male, Heart Failure, United Kingdom