New device shows promise for managing heart failure in primary care
A remote sensor that non-invasively monitors lung fluid could help primary care doctors prevent heart failure hospitalizations, particularly in rural areas. A small feasibility trial found patients accepted the technology and healthcare providers saw potential demand, though questions remain about when to act on device readings that conflict with patient symptoms.
Originaltitel: Feasibility of a heart failure management programme using remote dielectric sensing technology for the noninvasive lung fluid monitoring in primary care: a mixed-methods study
AIM: Remote Dielectric Sensing (ReDS) technology non-invasively assesses lung congestion, but its value in primary care remains unknown. This study aimed to evaluate the feasibility of a ReDS-guided heart failure (HF) management programme in primary care. METHODS AND RESULTS: The one-month programme, including ReDS measurements, a decision support algorithm for diuretic adjustments, follow-up, and support for patient symptom monitoring, was provided to 18 patients with HF (mean age 81 years, mean ReDS values 33.6±6.0 indicating optimal volume status) in one rural primary care centre. The feasibility areas of acceptability, demand, implementation, practicality, and limited efficacy were evaluated in a mixed-methods study. Data were collected from 18 patients with HF and two health care professionals (HCPs) at baseline and one month follow-up. Acceptability: Patients found the programme satisfactory, while HCPs expressed uncertainty about using the algorithm for patients with deviating ReDS values but no worsening symptoms. Demand: Patients recognised the potential to prevent hospitalisations. HCPs perceived higher demand in rural settings. Practicality: The ReDS technology was found practical and easy to use. Implementation: Fidelity was partial, with algorithm-recommended clinical actions not always implemented. Limited efficacy: Self-care improved with a medium effect size and N-terminal pro-B-type natriuretic peptide (NT-proBNP), with a small effect size. No adverse events were reported. CONCLUSION: Our study demonstrates the feasibility of a ReDS-guided HF management programme, which may enable early detection of subclinical congestion and improving outcomes for patients with HF in primary settings. Further effort is necessary to refine the algorithm and improve its fidelity.