Abstract
Background
The Heart Health Hub (HHH) is a virtual model of care for patients with newly diagnosed heart failure. A program pilot commenced in April 2020 and aimed to achieve acceptable titration rates for heart failure medications while improving patient access to services. This study aimed to investigate whether the virtual HHH service could deliver feasible, safe and acceptable titration outcomes.
Methods
A single-arm observational cohort study design was adopted. Eligible heart failure patients currently receiving care could consent to be enrolled in the pilot virtual HHH program based on pre-defined inclusion and exclusion criteria. Data on patient demographics, clinical characteristics and heart failure medication titration rates were obtained from routine health system databases and patient notes. Patient satisfaction data were collected using a Likert-scale questionnaire. Overall health service use and costs for each patient were obtained from health system databases for a period of 12 months following enrolment in the virtual HHH program.
Results
A total of 89 heart failure patients were included in the evaluation. Of these, 95% reached titration to either guideline-recommended target doses or maximum tolerated doses for both angiotensin-converting enzyme inhibitor/angiotensin receptor blockers/angiotensin and angiotensin receptor–neprilysin inhibitor (ACEI/ARB/ARNI) and beta-blockers combined. The mean number of days to achieve titration ranged from 20.2 days for mineralocorticoid receptor antagonist drugs, between 27.5 to 32.3 days for ACEI/ARB/ARNI drugs and 41.0 days for beta-blockers; 70 (79%) patients completed the satisfaction survey at least once, with more than 98% of survey questions receiving a positive response. The average monthly equipment and consumables cost per patient was $277 in year 2021/22.
Conclusion
This study provides evidence that a virtual model of care for newly diagnosed heart failure patients was feasible, safe and acceptable, with high titration rates, relatively rapid times to titration, strong patient satisfaction outcomes and relatively low equipment costs.
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References
Supplementary Material
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