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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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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