Monitoring patients with Heart Failure, what scientific evidence supports Tucuvi's protocols?

One of our first projects was the monitoring of patients with Heart Failure, together with the Hospital Ramón y Cajal (Madrid). This opportunity helped us to start generating the scientific evidence behind our protocols.

For more than 2 years Tucuvi has been working on monitoring protocols for patients with heart failure, as it is one of the most significant chronic pathologies. But what is the data behind this statement? And what scientific evidence supports our protocols?

Heart failure in Spain: where do we stand?

Heart failure (HF) is a complex syndrome involving the inability of the heart to pump a sufficient amount of blood efficiently. The disease is characterised by a changing response to drug treatment, multiple hospital admissions and numerous symptoms that limit the patient’s daily activity. It is a major problem in Spain, with an estimated 1.89% of the population over 18 years old suffering from the disease.

The management of HF consumes large healthcare resources, with the annual cost per patient being close to 6,500 euros, which represents 3.8% of the overall healthcare expenditure in our country. According to the study ‘Costs and use of medical care in patients with heart failure in Spain‘, the greatest determinant of the economic burden of heart failure are hospitalisations, which account for 75.8% of the total bill.

It is estimated that HF accounts for more than 25% of all admissions for heart disease in Spain, and is the leading cause of hospitalisation in people over 65 years old. Moreover, studies conducted by the Spanish Society of Cardiology (SEC) and included in the RECALCAR project indicate that the percentage of 30-day readmissions associated with HF averages 9.3% in Spain, while the 60-90 day rehospitalisation rate ranges between 25-30%.

Optimisation of resources and continuous and integrated care

Over the last few years, there have been important advances in the care of patients with HF, as can be seen in the incidence of hospitalisation, which has decreased by 49.45% between 2015 and 2019. Despite this, there is still room for improvement, which is an important therapeutic objective and one of the main challenges for our healthcare system.

In order for the HF care model to allow sustainable management of the disease, an integral approach to the patient is necessary, along with optimal, personalised and appropriate care for all profiles. In addition, another fundamental factor is continuity of care, with tools and processes that guarantee coordination between the different levels of healthcare and provide better health outcomes for the patient. Thus, some of the objectives pursued with this healthcare model are as follows:

  • Early detection and treatment of possible signs of cardiac decompensation (disease prevention).
  • Reduce hospital readmissions and emergency room visits, avoiding unnecessary travel.
  • Reducing the socio-economic burden associated with these hospitalisations, through better optimisation of health system resources.
  • Improve health outcomes and patient experience throughout the care pathway.

Pilot study to evaluate the use of Tucuvi's virtual assistant in the follow-up of patients with HF

One of our first projects was a pilot study based on the monitoring of elderly patients with Heart Failure, within the Internal Medicine Heart Failure Unit of the Ramón y Cajal Hospital (Madrid). In addition, the project was supported by the Innovation Unit of the IRYCIS, belonging to the Innovation Platform for Medical and Health Technologies (ITEMAS).

The main objective of the study was to evaluate the technical feasibility of implementing our solution in a clinical setting, specifically in the follow-up of elderly patients with HF in a specialised unit. At the same time, we also sought to study the effect of this implementation on the different agents involved: patients, clinical team and healthcare system. Secondary objectives included collecting information on clinical aspects, associated socio-health costs, data protection, and participant satisfaction and confidence.

"This project can help to implement technologies in the clinical environment to automate monitoring strategies for chronic patients, providing a solution to meet the growing needs of healthcare systems.Pilot study team

IRYCIS - Tucuvi

For the development of the project, an experimental design of a pilot clinical study was proposed, with a single group of patients and a duration of 12 weeks. We defined up to 4 different types of telephone interactions with the patients included in the protocol:

  • Medication reminder calls: made three times a day, i.e. at each intake.
  • Clinical assessment calls: established on a weekly basis, with the aim of clinically assessing the patient to identify possible signs of decompensation and predict worsening as early as possible.
  • Calls to remind the patient of hygiene measures and the control of vital signs: made on a monthly basis.
  • Reminder of medical appointments: established on an occasional basis, when the Unit team made appointments with the patient.

What impact did the follow-up have on patients?

Compared to standard follow-up, one of the most important aspects for patients was being able to receive follow-up from home, in a comfortable and safe environment and in continuous contact with the hospital. In addition, the waiting times perceived by these patients were reduced, with increased speed of communication with the clinical team being highlighted by these patients.

Moreover, they also gained a better understanding of their disease by taking responsibility for monitoring and participating in their own treatment, enhancing health education and self-care. This supported adherence to scheduled treatment, while ensuring preventive care with early detection of disease decompensation and more efficient treatment of decompensation.

Conclusions of the project

In this study, it was found that Tucuvi’s solution allowed to obtain information about the health of the HF patient automatically in a familiar environment; thus, responding to the need for continuous assistance to these patients. In addition, it was stated that it is a tool that enables the monitoring of a greater number of patients in a simultaneous, scalable and accessible way, thanks to the fact that the communication channel is personalised telephone calls.

At the same time, bidirectional communication between the healthcare team and the patient was facilitated more frequently than in conventional monitoring. Thus, the benefits obtained were translated into the design of new care processes to improve the quality of life of patients and reduce the care burden, while at the same time playing an important role in organising the growing demand for healthcare.

In this way, Tucuvi’s technology proved to be helpful in therapeutic optimisation, which is one of the main bases for increasing the efficiency of clinical processes, reducing hospitalisations and obtaining better health outcomes for all agents.

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