Does an eHealth Intervention Reduce Complications and Healthcare Resources? A mHeart Single-Center Randomized-Controlled Trial.
Mar Gomis-PastorSònia MirabetAnna De DiosVicenç Brossa LoidiLaura LopezRebeca Pelegrin CruzMaria Antonia ManguesPublished in: Journal of cardiovascular development and disease (2023)
(1) Background: In the mHeart trial, we showed that an eHealth intervention, mHeart, improved heart transplant (HTx) recipients' adherence to immunosuppressive therapy compared with the standard of care. Herein, we present the analysis assessing whether mHeart reduces complication frequency and healthcare resource use, and whether this reduction depends on patients' adherence. (2) Methods: The mHeart was a single-center randomized-controlled trial (IIBSP-MHE-2014-55) in 134 adult HTx recipients (n = 71 intervention; n = 63 controls). The endpoints were mortality, complications, and resource use during follow-up (mean 1.6 ± 0.6 years). (3) Results: A significantly lower proportion of HTx recipients in mHeart had echocardiographic alteration (2.8% vs. 13.8%; p = 0.02), cardiovascular events (0.35% vs. 2.4%; p = 0.006), infections (17.2% vs. 56%; p = 0.03), and uncontrolled Hba1c (40.8% vs. 59.6%; p = 0.03) than controls. In addition, a significantly lower proportion of patients in the intervention needed hospital (32.4% vs. 56.9%; p = 0.004) or urgent admissions (16.9% vs. 41.4%; p = 0.002) and emergency room visits (50.7% vs. 69.0%; p = 0.03). Adherence status (measured by the self-reported SMAQ) influenced only controls regarding hospitalizations and emergency room visits. Differences were not significant on deaths (intervention 4.2% vs. control 9.5%; p = 0.4) (4) Conclusions: the mHeart strategy significantly reduced the occurrence of the studied post-transplant complications and the need for medical attention in HTx recipients. Adherence status influenced controls in their need for medical care.
Keyphrases
- randomized controlled trial
- healthcare
- cardiovascular events
- end stage renal disease
- study protocol
- ejection fraction
- chronic kidney disease
- risk factors
- newly diagnosed
- emergency department
- peritoneal dialysis
- prognostic factors
- cardiovascular disease
- palliative care
- public health
- clinical trial
- heart failure
- coronary artery disease
- pulmonary hypertension
- type diabetes
- systematic review
- glycemic control
- kidney transplantation
- stem cells
- left ventricular
- adipose tissue
- young adults
- mitral valve
- metabolic syndrome
- pain management
- quality improvement
- insulin resistance
- cell therapy
- phase iii
- skeletal muscle
- patient reported
- open label
- phase ii
- replacement therapy
- acute care
- emergency medical