Evaluation of the Impact of Remote Titration Combined with Telemonitoring on the Optimization of Guideline Directed Medical Therapy for Patients with Heart Failure
Year: 2020
Type: dissertation
Abstract: To improve health outcomes in heart failure patients, guideline directed medical therapy (GDMT) should be optimized to maximal tolerated doses. However, GDMT remains underutilized, with less than 25% of patients receiving target doses in clinical practice. The objective of this research was to determine the effectiveness of remote titration facilitated by telemonitoring and identify factors that promote or impede remote titration. A randomized controlled trial (N=108) was designed to compare a remote titration strategy with a standard titration program. Analysis of a pilot cohort of 42-patients found that telemonitoring increased the proportion of patients that achieved target doses (90.5% vs. 52.4%), decreased time to dose optimization (12.26 vs. 19.01 weeks), and reduced the number of clinic visits by 50%. Facilitators to remote titration included the ease-of-use and utility of the intervention while barriers included the resources and funding required. This study provided evidence that remote titration can be effectively facilitated by telemonitoring.
Source: TSpace (University of Toronto)
Author: Veronica Kirk
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3158018572