Mitchell Psotka, MD, PhD, is the Section Chief of Inova’s Heart Failure & Transplant Program. He is board-certified in cardiovascular disease, advanced heart failure and transplant cardiology, and internal medicine. He practices at the Inova Heart and Vascular Institute in Falls Church, VA and is a co-principal investigator of the HF-eVOLUTION study.
Akshay Desai, MD, is Director of the Cardiomyopathy and Heart Failure programs at Brigham and Women’s Hospital, and an associate professor of medicine at Harvard Medical School. He is a co-principal investigator of the HF-eVOLUTION study.
From the exponential rise in the use of telehealth to a greater need for decentralized clinical trials and remote monitoring, digital health tools have proven to be valuable – even life-saving – amidst the COVID-19 pandemic. Continued innovation in digital health is critical to further increase access and connect patients and physicians as we move beyond traditional clinic settings.
More than 6 million adults in the United States are living with heart failure. It’s a life-threatening condition that can be difficult to manage, and the leading cause of hospitalization for people over 65. But it is treatable.
A variety of medications are available to control the symptoms of heart failure and make weak hearts stronger over time. But treatment isn’t always straightforward. Many patients take multiple medications to improve heart function. Getting the right combination of drugs and dosages can be difficult.
A new digital health monitoring study hopes to change that. Researchers at the Inova Heart and Vascular Institute are collaborating with Brigham and Women’s Hospital in Boston (a teaching hospital of Harvard Medical School) to launch the HF-eVOLUTION study, with funding from Amgen, one of the world’s leading independent biotechnology companies. In collaboration with several other medical centers, the study will investigate whether digital medical technology data, including data from wearable devices, can help doctors better care for patients by prompting earlier interventions to improve their symptoms, function, and quality of life.
Managing Heart Failure with Medication
In people with heart failure, the heart doesn’t pump blood as well as it should. Too little oxygen reaches the body’s tissues, leading to debilitating symptoms such as chronic fatigue and shortness of breath.
Medications can improve heart function and save lives — when they’re used correctly. Unfortunately, those medications are underused. And patients who do take the medications don’t always get the best dose.
There are a number of possible reasons for this. Patients and doctors might be afraid to increase the dose of a medication because of the risk of side effects, or because the patient is feeling well. But even patients who feel good might benefit from higher doses of the drugs.
Time is also an issue. When patients see their doctors infrequently, their health can decline a lot between appointments.
By using digital technology to monitor patients around the clock, cardiologists can keep closer tabs on symptoms and side effects. They can also make medication adjustments as soon as they’re needed, instead of waiting until the next office visit.
Embracing Medical Technology
The HF-eVOLUTION study is designed to help doctors and patients better manage their heart failure medications. Participants will wear a Biobeat wristband to collect health data. But it’s a lot more than your average smart watch or fitness tracker. The FDA-cleared device collects heart rate, oxygen saturation and changes in blood pressure. It is the first FDA-cleared device that can measure blood pressure without a cuff.
The device data is paired on a Datos software platform with patient data collected by smartphone, so their health data can be sent to doctors in real time. Patients will also receive a smart scale to measure their body weight. That will allow doctors to track whether they are retaining water, a common side effect of heart failure.
Data matters, but it’s also helpful for doctors to hear from patients how they’re feeling. Each participant in the study will be sent regular questionnaires via their smartphones. With a few clicks, they’ll be able to answer questions about their symptoms, physical activity and quality of life.
All of the information from the sensors and the surveys will be automatically uploaded into easy-to read graphs and reports that doctors can access anytime, anywhere. We hope these tools will help doctors make quicker, more informed decisions, so that patients can receive the best, most personalized care.
Improving Heart Failure Treatment
Heart failure is a contributing factor in 1 of every 8 deaths in the United States. That’s troubling, especially when we have medications that can help save lives. It’s our hope that digital technology can help doctors make better decisions.
Our current healthcare system focuses on “sick care:” treating people after a significant health event, or, once the damage is done. Digital health technology can help shift this focus by empowering them with their own data.
Those interested in being considered for enrollment should email IHVIResearch@inova.org.
At Inova, we’re excited to be collaborating with some of the leading heart centers on the east coast as we find new ways to improve heart failure treatment. Participating in studies such as HF-eVOLUTION help us achieve our mission of providing the best, most innovative care for our heart patients.