TY - JOUR
T1 - Digital Solutions to Optimize Guideline-Directed Medical Therapy Prescriptions in Heart Failure Patients
T2 - Current Applications and Future Directions
AU - Man, Jelle P
AU - Klopotowska, Joanna E.
AU - Asselbergs, Folkert W
AU - Handoko, M Louis
AU - Chamuleau, Steven A J
AU - Schuuring, Mark J
N1 - Publisher Copyright: © The Author(s) 2024.
PY - 2024/4/1
Y1 - 2024/4/1
N2 - Purposeof Review: Guideline-directed medical therapy (GDMT) underuse is common in heart failure (HF) patients. Digital solutions have the potential to support medical professionals to optimize GDMT prescriptions in a growing HF population. We aimed to review current literature on the effectiveness of digital solutions on optimization of GDMT prescriptions in patients with HF. Recent Findings: We report on the efficacy, characteristics of the study, and population of published digital solutions for GDMT optimization. The following digital solutions are discussed: teleconsultation, telemonitoring, cardiac implantable electronic devices, clinical decision support embedded within electronic health records, and multifaceted interventions. Effect of digital solutions is reported in dedicated studies, retrospective studies, or larger studies with another focus that also commented on GDMT use. Overall, we see more studies on digital solutions that report a significant increase in GDMT use. However, there is a large heterogeneity in study design, outcomes used, and populations studied, which hampers comparison of the different digital solutions. Barriers, facilitators, study designs, and future directions are discussed. Summary: There remains a need for well-designed evaluation studies to determine safety and effectiveness of digital solutions for GDMT optimization in patients with HF. Based on this review, measuring and controlling vital signs in telemedicine studies should be encouraged, professionals should be actively alerted about suboptimal GDMT, the researchers should consider employing multifaceted digital solutions to optimize effectiveness, and use study designs that fit the unique sociotechnical aspects of digital solutions. Future directions are expected to include artificial intelligence solutions to handle larger datasets and relieve medical professional’s workload.
AB - Purposeof Review: Guideline-directed medical therapy (GDMT) underuse is common in heart failure (HF) patients. Digital solutions have the potential to support medical professionals to optimize GDMT prescriptions in a growing HF population. We aimed to review current literature on the effectiveness of digital solutions on optimization of GDMT prescriptions in patients with HF. Recent Findings: We report on the efficacy, characteristics of the study, and population of published digital solutions for GDMT optimization. The following digital solutions are discussed: teleconsultation, telemonitoring, cardiac implantable electronic devices, clinical decision support embedded within electronic health records, and multifaceted interventions. Effect of digital solutions is reported in dedicated studies, retrospective studies, or larger studies with another focus that also commented on GDMT use. Overall, we see more studies on digital solutions that report a significant increase in GDMT use. However, there is a large heterogeneity in study design, outcomes used, and populations studied, which hampers comparison of the different digital solutions. Barriers, facilitators, study designs, and future directions are discussed. Summary: There remains a need for well-designed evaluation studies to determine safety and effectiveness of digital solutions for GDMT optimization in patients with HF. Based on this review, measuring and controlling vital signs in telemedicine studies should be encouraged, professionals should be actively alerted about suboptimal GDMT, the researchers should consider employing multifaceted digital solutions to optimize effectiveness, and use study designs that fit the unique sociotechnical aspects of digital solutions. Future directions are expected to include artificial intelligence solutions to handle larger datasets and relieve medical professional’s workload.
KW - Digital health
KW - Digital solutions
KW - GDMT
KW - Guideline recommendations
KW - Heart failure
KW - eHealth
UR - http://www.scopus.com/inward/record.url?scp=85185132237&partnerID=8YFLogxK
U2 - 10.1007/s11897-024-00649-x
DO - 10.1007/s11897-024-00649-x
M3 - Review article
C2 - 38363516
SN - 1546-9530
VL - 21
SP - 147
EP - 161
JO - Current Heart Failure Reports
JF - Current Heart Failure Reports
IS - 2
ER -