Digital Solutions to Optimize Guideline-Directed Medical Therapy Prescriptions in Heart Failure Patients: Current Applications and Future Directions.

IF 3.8 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Current Heart Failure Reports Pub Date : 2024-04-01 Epub Date: 2024-02-16 DOI:10.1007/s11897-024-00649-x
Jelle P Man, Joanna Klopotowska, Folkert W Asselbergs, M Louis Handoko, Steven A J Chamuleau, Mark J Schuuring
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Abstract

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. 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.

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优化心衰患者指导性医疗处方的数字化解决方案:当前应用与未来方向》。
综述目的:在心力衰竭(HF)患者中,指南指导下的医疗疗法(GDMT)使用不足的情况很常见。数字解决方案有可能帮助医疗专业人员在不断增长的心衰患者中优化 GDMT 处方。我们旨在回顾目前有关数字解决方案对优化高血压患者 GDMT 处方有效性的文献:我们报告了已发表的 GDMT 优化数字解决方案的疗效、研究特点和适用人群。我们讨论了以下数字解决方案:远程会诊、远程监控、心脏植入式电子设备、嵌入电子健康记录的临床决策支持以及多方面干预。数字解决方案的效果在专门研究、回顾性研究或大型研究中有所报道,这些研究的另一个重点也对 GDMT 的使用进行了评论。总体而言,我们看到更多关于数字化解决方案的研究报告称,GDMT 的使用率显著提高。但是,在研究设计、所用结果和研究人群方面存在很大的异质性,这阻碍了对不同数字化解决方案的比较。本文讨论了障碍、促进因素、研究设计和未来方向。目前仍然需要设计良好的评估研究,以确定用于优化高血压患者 GDMT 的数字化解决方案的安全性和有效性。根据本综述,应鼓励在远程医疗研究中测量和控制生命体征,应积极提醒专业人员注意不理想的 GDMT,研究人员应考虑采用多方面的数字解决方案来优化效果,并使用适合数字解决方案独特的社会技术方面的研究设计。预计未来的研究方向将包括人工智能解决方案,以处理更大的数据集,减轻医疗专业人员的工作量。
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来源期刊
Current Heart Failure Reports
Current Heart Failure Reports Medicine-Emergency Medicine
CiteScore
5.30
自引率
0.00%
发文量
44
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of heart failure. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as investigative, pharmacologic, and nonpharmacologic therapies, pathophysiology, and prevention. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
期刊最新文献
Cardiogenic Shock: Focus on Non-Cardiac Biomarkers. Biomarkers of Hemodynamic Congestion in Heart Failure. Heart Failure in Rheumatoid Arthritis: Clinical Implications. Screening for Heart Failure: Biomarkers to Detect Heightened Risk in the General Population. Troponin Elevation in Asymptomatic Cancer Patients: Unveiling Connections and Clinical Implications.
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