Initial data from the HFOS1 study : High adherence to telemonitoring in congestive heart failure patients is associated with lower all-cause mortality and hospitalization
T Garban, B Lequeux, A Pathak, R SabatierAbstract
Background
Adherence is a pivotal determinant of remote monitoring program (RMP) efficacy in chronic heart failure (CHF), yet remains insufficiently characterized in real-world settings. This study aimed to identify determinants of low adherence and evaluate its prognostic impact on mortality and rehospitalization in a nationwide RM cohort.
Methods
HFOS1 is a real-world, large scale, observational study including 2,621 French chronic HF patients enrolled between Jan 2022 and Dec 2024 in a nationwide RMP using the Optified-Self™ platform, a fullweb software allowing to collect and assess patient adherence. Patients were categorized as high / low adherent based on a threshold of 70 %. The primary endpoint was the event-free survival (EFS) defined as the time from enrolment to the first occurrence of all-cause death or rehospitalization. We also identified risk factors associated with low adherence using univariate and multivariate logistic regression, and an exploratory hierarchical clustering.
Results
Low adherent patients (n=635, 24.2%) were younger (72 vs 75 years, p<0.001), more symptomatic (NYHA III-IV: 144 (37%) vs 344 (28%), p<0.001) more frequently monitored daily (594 (94 %) vs 1215 (61%) p<0.001), with RPM initiated more often in ambulatory settings. Patients with low RMP adherence (≤70%) exhibited a significantly higher risk of the primary endpoint of all-cause mortality or hospitalization compared with those demonstrating high adherence (>70%) (adjusted Hazard Ratio [aHR]: 1.89; 95% Confidence Interval [CI]: 1.47–2.44; p < 0.001). Eventfree survival curves began to diverge as early as three months after inclusion, indicating an early and sustained benefit of higher adherence.
Conclusions
In the HFOS1 study,high adherence to RMP in congestive heart failure patient is associated with lower all-cause mortality and hospitalization. Benefits varied according to patients’ profile suggesting the need to personalize and optimize RMP.For image description, please refer to the figure legend and surrounding text.