Combined Digital Interventions for Enhancing Heart Failure Continuum Care and Their Impact on Care Consumption: A Randomized Controlled Trial

Digital health solutions are increasingly used in heart failure (HF) management to optimize resources. However, their full effectiveness remains unclear. The objective of this study was to assess if by enhancing remote patient follow-up, optimizing guideline directed medical treatment (GDMT), and positively influencing patient behavior, digital solutions could lead to a significant reduction in overall care consumption. In this 12-week randomized controlled trial, a mobile app-based remote patient monitoring, digital therapeutics, and clinical decision support tools were combined to assess its impact on healthcare consumption. A total of 111 HF patients were randomly assigned (1:1) to either the Continuum intervention or usual care. Intent-to-treat analysis revealed trends favoring the intervention. Per-protocol analysis on cardiac events were in favor of the intervention group and showed significant lower costs (mean CAD $1,302 vs. $3,635, p = 0.035), number of patients affected (3 vs. 11, p = 0.041), total event days (66 vs. 127, p = 0.036), and time to the first event (95% CI 1.055–13.56, p = 0.028). Highly compliant patients (n = 17, 33%) had no cardiac events and represented 8% of the costs. The mean cost of the intervention was $172. These findings warrant further investigation with larger studies to confirm the efficacy and cost-effectiveness of this combined complex digital solution intervention. ClinicalTrials.gov registration: NCT05377190