An intensive telemonitoring strategy based on automated text messaging may benefit heart failure (HF) patients in the vulnerable period following hospitalization, according to a study published in JAMA Cardiology.
Readmissions following HF hospitalization are a major problem in cardiovascular care. To address this challenge, investigators designed the MESSAGE-HF trial, which was conducted in 30 HF clinics in Brazil and comprised nearly 700 patients (65.8% men; mean age, 61 years). Study participants were randomly assigned to a telemonitoring strategy, which included 4 daily short text messages that were intended to enhance self-care, engagement, and early intervention, or a standard-of-care group. Any text messaging feedback that triggered red flags led to diuretic adjustment and/or a telephone call from the health care team.
The primary outcome of interest was defined as change in N-terminal pro–brain natriuretic peptide (NT-proBNP) from baseline to 180 days.
Telemonitoring Strategy Successful
According to the findings, the HF telemonitoring system notably increased self-care compared with the standard-0f-care group (score difference at 30 days, −2.21; 95% CI, −3.67 to −0.74; P=.001; score difference at 180 days, −2.08; 95% CI, −3.59 to −0.57; P=.004). The investigators noted that the variation of NT-proBNP was similar in the telemonitoring group compared with the standard-of-care group (telemonitoring: baseline, 2593 pg/mL; 95% CI, 2314-2923; 180 days, 1313 pg/mL; 95% CI, 1117-1543; standard of care: baseline, 2396 pg/mL; 95% CI, 2122-2721; 180 days, 1319 pg/mL; 95% CI, 1114-1564; ratio of change, 0.92; 95% CI, 0.77-1.11; P=.39).
“An intensive telemonitoring strategy applied in the vulnerable period after an HF admission was feasible, well-accepted, and increased scores of HF self-care, but did not translate to reductions in NT-proBNP levels nor improvement in a composite hierarchical clinical outcome,” the researchers concluded.
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