An online enhanced care program to improve the wellbeing of patients discharged from hospital with heart failure

Authors
Kirsty Fakes, Bree Hobden, Nicholas Zwar, Nicholas Collins, Christopher Oldmeadow, Francesco Paolucci, Michael McGee

Introduction: Depression is highly prevalent and associated with increased hospitalisations and mortality among patients diagnosed with heart failure. This study aims to evaluate the effectiveness and cost-effectiveness of an online wellbeing program for patients discharged from hospital with heart failure in (i) improving emotional and physical wellbeing, and (ii) decreasing healthcare utilisation.

Methods: Two-arm randomised controlled trial (RCT). Eligible patients hospitalised with heart failure recruited pre-discharge from two hospitals in NSW. Participants are randomised to receive the intervention (an online enhanced community care program for heart failure: “Enhanced HF Care”) or usual care (control). The Enhanced HF Care program includes health education and regular monitoring of depression and clinical outcomes via fortnightly/monthly surveys for six months, with participants offered tailored self-care advice, via video and written information. Cardiac nurses track real-time patient data from a dashboard and receive automated email alerts when patients report high levels of depression or clinical symptoms, to action where needed. General practitioners also receive automated alerts if patients report high-risk survey responses and are encouraged to schedule a patient consultation.

Outcomes: Quality of Life (Emotional and Physical subscales of the Minnesota Living with Heart Failure questionnaire: co-primary outcomes), and healthcare utilisation (secondary outcome) at one and six-months post-recruitment. Results: Recruitment commenced in July 2023. To-date, 28 participants are enrolled in the RCT (n=15 intervention, n=13 control). Preliminary findings will be presented at the conference.

Conclusions: This study has the potential to reduce the burden of depression for patients with heart failure. "