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
- study protocol
- end stage renal disease
- ejection fraction
- newly diagnosed
- emergency department
- risk factors
- coronary artery disease
- chronic kidney disease
- public health
- cardiovascular disease
- risk assessment
- prognostic factors
- heart failure
- peritoneal dialysis
- palliative care
- atrial fibrillation
- working memory
- systematic review
- mitral valve
- pulmonary hypertension
- metabolic syndrome
- glycemic control
- adipose tissue
- patient reported
- open label
- meta analyses