Triage‐HF Plus: a novel device‐based remote monitoring pathway to identify worsening heart failure

Abstract Aims Remote monitoring of patients with physiological data derived from cardiac implanted electronic devices (CIEDs) offers potential to reconfigure clinical services. The ‘Heart Failure Risk Score' (HFRS) uses input from integrated device physiological monitoring to risk‐stratify pati...

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Main Authors: Fozia Zahir Ahmed, Joanne K. Taylor, Caroline Green, Lucy Moore, Angelic Goode, Paula Black, Lesley Howard, Catherine Fullwood, Amir Zaidi, Alison Seed, Colin Cunnington, Manish Motwani
Format: Article
Language:English
Published: Wiley 2020-02-01
Series:ESC Heart Failure
Subjects:
Online Access:https://doi.org/10.1002/ehf2.12529
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spelling doaj-2cacb733b79e47e29162354e96d13d5c2020-11-25T01:29:03ZengWileyESC Heart Failure2055-58222020-02-017110811710.1002/ehf2.12529Triage‐HF Plus: a novel device‐based remote monitoring pathway to identify worsening heart failureFozia Zahir Ahmed0Joanne K. Taylor1Caroline Green2Lucy Moore3Angelic Goode4Paula Black5Lesley Howard6Catherine Fullwood7Amir Zaidi8Alison Seed9Colin Cunnington10Manish Motwani11Manchester Heart Centre Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre Manchester UKManchester Heart Centre Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre Manchester UKManchester Heart Centre Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre Manchester UKManchester Heart Centre Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre Manchester UKLancashire Cardiac Centre Blackpool Victoria Hospital Blackpool UKLancashire Cardiac Centre Blackpool Victoria Hospital Blackpool UKLancashire Cardiac Centre Blackpool Victoria Hospital Blackpool UKManchester Academic Health Science Centre, Research and Innovation Central Manchester University Hospitals NHS Foundation Trust Manchester UKManchester Heart Centre Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre Manchester UKLancashire Cardiac Centre Blackpool Victoria Hospital Blackpool UKManchester Heart Centre Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre Manchester UKManchester Heart Centre Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre Manchester UKAbstract Aims Remote monitoring of patients with physiological data derived from cardiac implanted electronic devices (CIEDs) offers potential to reconfigure clinical services. The ‘Heart Failure Risk Score' (HFRS) uses input from integrated device physiological monitoring to risk‐stratify patients as low‐risk, medium‐risk, or high‐risk of a heart failure event in the next 30 days. This study aimed to evaluate a novel clinical pathway utilizing a combination of CIED risk‐stratification and telephone triage to identify patients with worsening heart failure (WHF). Methods and results A prospective, single‐centre, real‐world evaluation of the ‘Triage‐HF Plus' clinical pathway (HFRS in combination with telephone triage) over a 27 month period. One hundred and fifty‐seven high‐risk HFRS transmissions were referred for telephone triage assessment. Interventions were at the discretion of the clinical assessor acting in accordance with clinical guidelines. An additional 3month consecutive sample of low and medium HFRS transmissions (control group) were also contacted for telephone triage assessment (n = 98). Successful telephone contact was made in 127 (81%) of referred high‐risk HFRS cases: 71 (55.9%) were confirmed to have WHF requiring intervention; 19 (14.9%) had an alternative acute medical problem; one patient had been recently discharged from hospital with WHF; and 36 (28.0%) had no apparent cause for the high score. In the control group, only one patient had symptoms of WHF. The sensitivity and specificity of CIED‐based remote monitoring to identify WHF 98.6% (92.5–100.0%) and 63.4% (55.2–71.0%), respectively. Conclusions The Triage‐HF Plus clinical pathway is a potentially useful remote monitoring tool for patients with heart failure and in situ CIEDs.https://doi.org/10.1002/ehf2.12529Health care innovationPatient centred careDisease managementHealth care delivery systemsTelemedicineIntegrated diagnostics
collection DOAJ
language English
format Article
sources DOAJ
author Fozia Zahir Ahmed
Joanne K. Taylor
Caroline Green
Lucy Moore
Angelic Goode
Paula Black
Lesley Howard
Catherine Fullwood
Amir Zaidi
Alison Seed
Colin Cunnington
Manish Motwani
spellingShingle Fozia Zahir Ahmed
Joanne K. Taylor
Caroline Green
Lucy Moore
Angelic Goode
Paula Black
Lesley Howard
Catherine Fullwood
Amir Zaidi
Alison Seed
Colin Cunnington
Manish Motwani
Triage‐HF Plus: a novel device‐based remote monitoring pathway to identify worsening heart failure
ESC Heart Failure
Health care innovation
Patient centred care
Disease management
Health care delivery systems
Telemedicine
Integrated diagnostics
author_facet Fozia Zahir Ahmed
Joanne K. Taylor
Caroline Green
Lucy Moore
Angelic Goode
Paula Black
Lesley Howard
Catherine Fullwood
Amir Zaidi
Alison Seed
Colin Cunnington
Manish Motwani
author_sort Fozia Zahir Ahmed
title Triage‐HF Plus: a novel device‐based remote monitoring pathway to identify worsening heart failure
title_short Triage‐HF Plus: a novel device‐based remote monitoring pathway to identify worsening heart failure
title_full Triage‐HF Plus: a novel device‐based remote monitoring pathway to identify worsening heart failure
title_fullStr Triage‐HF Plus: a novel device‐based remote monitoring pathway to identify worsening heart failure
title_full_unstemmed Triage‐HF Plus: a novel device‐based remote monitoring pathway to identify worsening heart failure
title_sort triage‐hf plus: a novel device‐based remote monitoring pathway to identify worsening heart failure
publisher Wiley
series ESC Heart Failure
issn 2055-5822
publishDate 2020-02-01
description Abstract Aims Remote monitoring of patients with physiological data derived from cardiac implanted electronic devices (CIEDs) offers potential to reconfigure clinical services. The ‘Heart Failure Risk Score' (HFRS) uses input from integrated device physiological monitoring to risk‐stratify patients as low‐risk, medium‐risk, or high‐risk of a heart failure event in the next 30 days. This study aimed to evaluate a novel clinical pathway utilizing a combination of CIED risk‐stratification and telephone triage to identify patients with worsening heart failure (WHF). Methods and results A prospective, single‐centre, real‐world evaluation of the ‘Triage‐HF Plus' clinical pathway (HFRS in combination with telephone triage) over a 27 month period. One hundred and fifty‐seven high‐risk HFRS transmissions were referred for telephone triage assessment. Interventions were at the discretion of the clinical assessor acting in accordance with clinical guidelines. An additional 3month consecutive sample of low and medium HFRS transmissions (control group) were also contacted for telephone triage assessment (n = 98). Successful telephone contact was made in 127 (81%) of referred high‐risk HFRS cases: 71 (55.9%) were confirmed to have WHF requiring intervention; 19 (14.9%) had an alternative acute medical problem; one patient had been recently discharged from hospital with WHF; and 36 (28.0%) had no apparent cause for the high score. In the control group, only one patient had symptoms of WHF. The sensitivity and specificity of CIED‐based remote monitoring to identify WHF 98.6% (92.5–100.0%) and 63.4% (55.2–71.0%), respectively. Conclusions The Triage‐HF Plus clinical pathway is a potentially useful remote monitoring tool for patients with heart failure and in situ CIEDs.
topic Health care innovation
Patient centred care
Disease management
Health care delivery systems
Telemedicine
Integrated diagnostics
url https://doi.org/10.1002/ehf2.12529
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