Patients' experiences of home-based monitoring and standardized titration for heart failure with reduced ejection fraction
K Odefjord, S Synnergard, A Wallermark, T Mellberg, M Thonander, A OdellAbstract
Background
Management of heart failure with reduced ejection fraction (HFrEF) has evolved rapidly, prioritizing early initiation and titration of guideline-directed medical therapy (GDMT) to optimize outcomes. However, translating these recommendations into routine practice remains a major challenge. Home-based monitoring facilitates faster up-titration, reduces hospitalizations and mortality, and improves quality of life. However, evidence remains limited regarding the relationship between standardized titration protocols and the patient’s holistic experience of home-based monitoring. Further research is therefore required to explore both the technical aspects of titration and the lived experience of managing heart failure through home-based monitoring.
Purpose
The aim is to explore how patients with newly diagnosed heart failure perceive home-based monitoring and standardized medication titration.
Methods
A qualitative study was conducted including 20 patients with newly diagnosed heart failure. Patients were initially enrolled in the TELEFASTER-HF study and were subsequently invited to participate in this interview-based study. Semi-structured interviews were carried out six months after inclusion. The interviews were transcribed and then analysed using inductive qualitative content analysis. Patients’ experiences were identified and coded, then organized into subcategories and categories reflecting the manifest content, followed by identification of latent content through theme development.
Results
These are preliminary findings as the final analysis is currently in progress. A total of eleven men and nine women, with a mean age of 61.4 year (range 31-79 years) were included in the study and interviewed between February 2024 and August 2024. The analysis identified six distinct categories: navigating technological management, comprehending and managing standardized medication titration, transitioning from health to illness, adapting to a transformed daily reality, home-based monitoring providing a sense of calm, and digital accessibility. These categories culminated in two overarching themes: transformation of the patient’s everyday life following heart failure and experiencing security and confidence in managing a new life situation.
Conclusion
In conclusion, the majority of patients reported a positive experience with the home-based monitoring program, citing enhanced security, a sense of being acknowledged, and the clarity of the standardized titration schedule.