Evidence map›Paper›PMID 33141094›Full record

ArticleJMIR cardio2020

Impact of Remote Titration Combined With Telemonitoring on the Optimization of Guideline-Directed Medical Therapy for Patients With Heart Failure: Internal Pilot of a Randomized Controlled Trial.

Veronica Artanian, Heather J Ross, Valeria E Rac, Mary O'Sullivan, Darshan H Brahmbhatt, Emily Seto

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JMIR cardio, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04205513 (Randomized Controlled Trial of a Mobile Phone-based Telemonitoring Application Utilized for the Facilitation of Medication Titration for Patients With Heart Failure), which is not on this map. Cited by 16 papers.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed
1.5field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04205513 naunknown statusnot on this map

Randomized Controlled Trial of a Mobile Phone-based Telemonitoring Application Utilized for the Facilitation of Medication Titration for Patients With Heart Failure

TypeinterventionalSponsorUniversity Health Network, TorontoRan2019 to 2024Enrolled108ConditionsHeart FailureArmsMedly
3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 24 citations in OpenAlex.

  1. Trial
  2. Article
  3. Observational
  4. Review
  5. Article
  6. Review
  7. Review
  8. Review
  9. Review
  10. Review
  11. Article
  12. VA Home Telehealth Program for Initiating and Optimizing Heart Failure Guideline-Directed Medical Therapy.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2023
    Article
  13. Article
  14. Review
  15. Article
  16. ERS/EAACI statement on adherence to international adult asthma guidelines.European respiratory review : an official journal of the European Respiratory Society · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Veronica ArtanianInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.ORCID https://orcid.org/0000-0003-1358-6357
Heather J RossInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.ORCID https://orcid.org/0000-0003-4384-3027
Valeria E RacInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.ORCID https://orcid.org/0000-0002-0426-4594
Mary O'SullivanPeter Munk Cardiac Centre, Division of Cardiology, University Health Network, Toronto, ON, Canada.ORCID https://orcid.org/0000-0002-6279-9319
Darshan H BrahmbhattDepartment of Medicine, University of Toronto, Toronto, ON, Canada.ORCID https://orcid.org/0000-0003-3440-0523
Emily SetoInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.ORCID https://orcid.org/0000-0002-8723-5915
University Health Network · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo improve health outcomes in patients with heart failure, guideline-directed medical therapy (GDMT) should be optimized to target doses. However, GDMT remains underutilized, with less than 25% of patients receiving target doses in clinical practice. Telemonitoring could provide reliable and real-time physiological data for clinical decision support to facilitate remote GDMT titration.

objectiveThis paper aims to present findings from an internal pilot study regarding the effectiveness of remote titration facilitated by telemonitoring.

methodsA 2-arm randomized controlled pilot trial comparing remote titration versus standard care in a heart function clinic was conducted. Patients were randomized to undergo remote medication titration facilitated by data from a smartphone-based telemonitoring system or standard titration performed during clinic visits.

resultsA total of 42 patients with new-onset (10/42, 24%) and existing (32/42, 76%) heart failure and a mean age of 55.29 (SD 11.28) years were randomized between January and June 2019. Within 6 months of enrollment, 86% (18/21) of patients in the intervention group achieved optimal doses versus 48% (10/21) of patients in the control group. The median time to dose optimization was 11.0 weeks for the intervention group versus 18.8 weeks for the control group. The number of in-person visits in the intervention group was 54.5% lower than in the control group.

conclusionsThe results of this pilot study suggest that remote titration facilitated by telemonitoring has the potential to increase the proportion of patients who achieve optimal GDMT doses, decrease time to dose optimization, and reduce the number of clinic visits. Remote titration may facilitate optimal and efficient titration of patients with heart failure while reducing the burden for patients to attend in-person clinic visits.

trial registrationClinicalTrials.gov NCT04205513; https://clinicaltrials.gov/ct2/show/NCT04205513. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/preprints.19705.

Indexed as

heart failuremHealthmonitoringremotetelemonitoringtitration

Identifiers

PMID33141094
PMCPMC7671843
OpenAlexW3046412187

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.