The Association of Digital Health Application Use with Heart Failure Care and Outcomes: Insights from CONNECT-HF
Rao VN, Kaltenbach LA, Granger BB, Fonarow GC, Al-Khalidi HR, Albert NM, Butler J, Allen LA, Lanfear DE, Ariely D, Miller JM, Brodsky MA, LaLonde TA, Lafferty JC, Granger CB, Hernandez AF, and DeVore AD. The Association of Digital Health Application Use with Heart Failure Care and Outcomes: Insights from CONNECT-HF. J Card Fail 2022.
Journal of cardiac failure
BACKGROUND: It is unknown if digital applications may improve guideline-directed medical therapy (GDMT) and outcomes in heart failure with reduced ejection fraction (HFrEF).
METHODS AND RESULTS: CONNECT-HF included an optional, prospective ancillary study of a mobile health application among hospitalized patients for HFrEF. Digital users were matched to nonusers from the usual care group. Co-primary outcomes included change in opportunity-based composite HF quality scores and HF rehospitalization or all-cause mortality. Among 2,431 patients offered digital applications across the United States, 1,526 (63%) had limited digital access or insufficient data, 425 (17%) were digital users, and 480 (20%) declined use. Digital users were similar in age to those who declined use (mean 58 vs. 60 years, p=0.031). Digital users (N=368) versus matched nonusers (N=368) had improved composite HF quality scores (48.0% vs. 43.6%; +4.76% [3.27-6.24]; p=0.001) and composite clinical outcomes (33.0% vs. 39.6%; HR 0.76 [0.59-0.97]; p=0.027).
CONCLUSIONS: Among participants in CONNECT-HF, use of digital applications was modest, yet associated with higher HF quality of care scores, including use of GDMT, and better clinical outcomes. While cause and effect cannot be determined from this study, the application of technology to guide GDMT use and dosing among patients with HFrEF warrants further investigation.
ePub ahead of print