as two first reason death and first consumer Global medical resources, as we all know, increasingly popular Cardiovascular disease (CVD) and its associated human and economic costs pose an increasingly unsustainable burden on humans and their health systems.
The stats speak for themselves – 82.6 million In the US alone, people are affected by heart disease at high cost $219 billion Each year involves health care services, medication and premature death.
High readmission rates primarily drive costs.For patients with heart failure (HF), almost 1 to 4 Readmission within 30 days of discharge, about half of readmissions within 6 monthsdespite the fact 25% of HF admissions are estimated to be preventable.
So why are our current approaches to managing heart disease failing to keep patients out of the hospital?
Well, treatment non-adherence in chronically ill patients is a notorious problem, including non-adherence to medication and remote monitoring.
WHO’s Multidimensional Adherence Model (MAM) emphasize The complexity of medication adherence. It may be influenced by the quality of the patient-clinician relationship, comorbidities, symptom severity, the complexity of the medication regimen in terms of dose and frequency, socioeconomic status, the patient’s knowledge and beliefs about their health, and the patient’s age and gender.
in patients with cardiovascular diseaseMedication non-adherence is further divided into unintentional factors, such as forgetting to take medication, and intentional factors, such as patients’ beliefs about their treatment and condition, both of which indicate a lack of effective communication and feedback loops that promote reinforcement, reassure and re-engage patients is the core of the problem.
In addition to medication adherence, another core issue is the current reactive approach to adjusting treatment plans, which is due to a lack of timely insight into the patient’s health status required during long-term monitoring and observation periods, leading clinicians with one arm behind their backs. A lost battle.
Until the past decade, receiving reliable, accurate information about patients’ vital signs and symptoms in real-time was a pipe dream. However, with the recent adoption of connected medical devices in response to the pandemic and the expansion of care beyond the clinical setting, real-time health insights are now able to inform more timely interventions and maximize patient outcomes. Collected by patients from the comfort of their own home, not only is more data available for better clinical decision-making, but the patient experience is also improved due to fewer office visits, said to increase the likelihood of adherence.
Nonetheless, while such digital health interventions have been found to reduce the risk of 30-day readmissions by 52% In heart failure patients, adherence to the RPM program remains a challenge. Patients struggle to consistently interact with multiple medical devices on a daily basis; they are impractical, difficult to coordinate, and battery life is an issue, especially for older patients who are traditionally more tech-averse.
This is not the only problem with home monitoring kits or even wearables, their passive nature helps to further improve the patient experience and thus patient compliance.
Universal problems require universal solutions, and the growing prevalence of heart disease means that reliance on additional equipment limits the scalability of digital health solutions and their impact. Access to care is limited to those with access to the equipment needed to keep themselves healthy.
“It is expensive to equip each patient with a kit,” prove Dr. Ravi Ramani, cardiologist at the University of Pittsburgh Medical Center.although prove RPM plans are more cost-effective than traditional care models, but still find From $275 to $7963 Each patient is provided with a kit each year, so it is not possible to provide a kit for each patient who needs it.
As a result, digital health tools that require additional hardware have limited capabilities and not only fail to overcome barriers to effective disease management, but they are also unsuitable for facilitating the mass screening needed to detect early risk factors and signs of heart disease, such as hypertension and atrial fibrillation; Early diagnosis and intervention can prevent the occurrence of cardiovascular disease.
The third way of care
To meet the aforementioned need for scalability, and in an effort to increase access to care, digital therapeutics (DTx) have emerged over the past 5 years as a new category of medicine; pure software tools that can augment or completely replace existing treatments, only Access is via an app on the patient’s smartphone.
To date, these evidence-based, clinically-assessed software have targeted mental health and behavioral conditions because the type of data is readily available, the current lack of objectivity in their measurements, and their similarity to existing treatments have facilitated their faster use. pear therapyFor example, the reSET system for substance use disorders was the first to receive FDA approval in 2017.
However, as they now expand to other diseases such as CVD that require regular physical fitness measurements, DTx face the same hurdles as conventional RPM programs without staying true to their raison d’être of scalability, cost-effectiveness, and ease of access.
Having said that, DTx now has an opportunity to leverage emerging technologies to measure medical-grade vital signs and other physiological parameters simply through patient interaction with a smartphone, without the need for additional hardware.
By doing so, physiological digital biomarkers can be established to develop cardiac self-management tools that engage, educate, and empower patients to adhere to their treatment plans, while providing clinicians with the comprehensive, real-time insights they need about their patients’ health. Historical insights to optimize interventions and patient outcomes.
This paired DTx companion tool will enable a new, third approach to care, along with in-person care and medication, which will serve as another string for clinicians, helping patients stay healthy longer.
Atrial fibrillation: the Achilles heel of cardiovascular disease
It’s a bold dream, but where do we start?
Smartphone-only physiological monitoring is a new technology, so of course investment and validation are required.
After evaluating the evidence generated to date and its potential to have the greatest immediate impact, it became clear that developing a scalable, low-cost method for the detection of atrial fibrillation (AF) must be its first application.
Atrial fibrillation is a common sustained cardiac arrhythmia.Here are the early symptoms associated with heart disease five times Increased risk of stroke, more severe stroke and heart failure In terms of higher mortality and disability, more than $26 billion in U.S. health care costs, and will increase 2.5 times The prevalence of the next 30 years will be one of the greatest epidemic and public health challenges we face.
Early detection and intervention can prevent two thirds AF-related stroke. However, as we have seen, until now we lacked the ability to perform population-wide mass screening for AF.
By putting the ability to detect AF in the hands of the 6 billion smartphone users worldwide, the validation of further physiological parameters will be accelerated, and subsequent application of this technology to DTx as a third modality of care will enable the use of low-cost tools to remove the Barriers to care and improving heart health.
Photo: hudiemm, Getty Images
