Effectiveness of the digital tool Care 4Hearts in monitoring patients with heart failure: a prospective study in Latinamerica

Abstract

In Latin America there are few experiences in telemonitoring are being conducted in heart failure patients. Virtual CORIC was designed as a prospective observational cohort study in accordance with the STROBE guidelines, ensuring transparency and thorough reporting. Patients using the Care 4 Hearts application were considered the exposed group, while those receiving standard care formed the control group. A total of 50 patients diagnosed with HF at our Medical Center were enrolled using block randomization Inclusion criteria were age ≥ 18 years, diagnosis of chronic HF (NYHA class IIIV), and access to a smartphone. The Care 4 Hearts app included medication reminders, symptom tracking, educational resources, and direct messaging with the HF care team. Patients in the control group received standard HF management. Statistical Analysis Data were analyzed using SPSS v.27. Categorical variables were expressed as frequencies and percentages, and continuous variables as means with standard deviations or medians with interquartile ranges. The Chi-square test (or Fisher's exact test) and Student's t-test (or Mann-Whitney U test) were used for comparisons. A pvalue < 0.05 was considered statistically significant. QALYs were calculated using the EQ-5D-5L tool, applying UK tariffs for utility values.50 patients in the study, of which 54.0% were women and with an average age of 78.5 years (devest=12.8 years). The etiology of heart failure Ischemic heart disease was the most common cause Other causes, including Chagas disease (4%, 95% CI: 0.67-12.59) and idiopathic dilated cardiomyopathy (2%, 95% CI: 0.10-9.46), Quality-adjusted life years (QALYs) were calculated, which allows for the analysis of health outcomes based on utility and is used to compare different programs or technologies. In this study, it was found that 1 year of life with the APP was 0.22 QALYs for a 10-year life expectancy with heart failure, which is equivalent to 2.2 quality adjusted life years, i.e., gains in quality of life. Therefore, 1 year of life with conventional treatment is 0.12 for a 10-year life expectancy with heart failure, which is equivalent to 1.2 quality-adjusted life years, i.e., gains in quality of life, and these differences are statistically significant (p=0.003). This study provides evidence of the potential of CARE 4HEARTS to improve adherence and quality of life in HF patients, aligning with previous studies on digital tools in chronic disease management.