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Okami S, Lecomte C, Raad H, Aguila M, Mohrova Z, Takeichi M, Tsuchiya T, Ohlmeier C, Evers T, Michel A. Initiation and continuation of pharmacological therapies in patients hospitalized for heart failure in Japan. Sci Rep 2024; 14:9095. [PMID: 38643208 PMCID: PMC11032365 DOI: 10.1038/s41598-024-60011-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 04/17/2024] [Indexed: 04/22/2024] Open
Abstract
Currently, the utilization patterns of medications for heart failure (HF) after worsening HF events remain unelucidated in Japan. Here, we conducted a retrospective cohort study evaluating the changes in HF drug utilization patterns in 6 months before and after hospitalizations for HF. The adherence to newly initiated HF medications was evaluated based on the proportion of days covered (PDC) and persistence as continuous treatment episodes among new users. The study included 9091 patients hospitalized for HF between January 2016 and September 2019, including 2735 (30.1%) patients who were newly prescribed at least one HF medication after hospitalization. Despite increases in the use of foundational HF therapy (beta-blockers, angiotensin-converting-enzyme inhibitors/angiotensin receptor blockers, or mineralocorticoid receptor antagonists), 35.6% and 7.6% of patients were treated with the HF foundational monotherapy or diuretics alone after hospitalization, respectively. The mean PDC of newly initiated HF medications ranged from 0.57 for thiazide diuretics to 0.77 for sodium-glucose cotransporter-2 inhibitors. Continuous use of HF medications during the first year after initiation was observed in 30-60% of patients. The mean PDC and one-year continuous HF medication use were consistently lower in patients aged ≥ 75 years and in patients with a history of HF hospitalization for all HF medication classes except for tolvaptan and digoxin. Despite the guideline recommendations of HF pharmacotherapy, both treatment and adherence were suboptimal after HF hospitalization, especially in vulnerable populations such as older patients and those with prior HF hospitalizations.
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Affiliation(s)
- Suguru Okami
- Medical Affairs & Pharmacovigilance, Bayer Yakuhin Ltd., Breeze Tower, 2-4-9 Umeda, Kita-Ku, Osaka, 530-0001, Japan.
| | | | | | | | | | - Makiko Takeichi
- Medical Affairs & Pharmacovigilance, Bayer Yakuhin Ltd., Breeze Tower, 2-4-9 Umeda, Kita-Ku, Osaka, 530-0001, Japan
| | - Takanori Tsuchiya
- Market Access & Public Affairs, Bayer Yakuhin, Ltd, 2-4-9 Umeda, Kita-Ku, Osaka, Japan
| | - Christoph Ohlmeier
- Integrated Evidence Generation & Business Innovation, Bayer AG, 13342, Berlin, Germany
| | - Thomas Evers
- Integrated Evidence Generation & Business Innovation, Bayer AG, 42096, Wuppertal, Germany
| | - Alexander Michel
- Integrated Evidence Generation & Business Innovation, Bayer Consumer Care AG, Peter Merian Straße 84, 4052, Basel, Switzerland
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Reimer LM, Nissen L, von Scheidt M, Perl B, Wiehler J, Najem SA, Limbourg FP, Tacke T, Müller A, Jonas S, Schunkert H, Starnecker F. User-centered development of an mHealth app for cardiovascular prevention. Digit Health 2024; 10:20552076241249269. [PMID: 38774157 PMCID: PMC11107323 DOI: 10.1177/20552076241249269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 04/08/2024] [Indexed: 05/24/2024] Open
Abstract
Background Mobile health (mHealth) apps can be used for cardiovascular disease (CVD) prevention. User-centered design, evidence-based content and user testing can be applied to ensure a high level of usability and adequate app access. Objective To develop and evaluate an mHealth app (HerzFit) for CVD prevention. Methods HerzFit´s development included a user-centered design approach and guideline-based content creation based on the identified requirements of the target group. Beta testing and a preliminary usability evaluation of the HerzFit prototype were performed. For evaluation, German versions of the System Usability Scale (SUS) and the mHealth App Usability Questionnaire (GER-MAUQ) as well as free text feedback were applied. Results User-centered design thinking led to the definition of four personas. Based on their requirements, HerzFit enables users to individually assess, monitor, and optimize their cardiovascular risk profile. Users are also provided with a variety of evidence-based information on CVD and their risk factors. The user interface and system design followed the identified functional requirements. Beta-testers provided feedback on the structure and functionality and rated the usability of HerzFit´s prototype as slightly above average both in SUS and GER-MAUQ rating. Participants positively noted the variety of functions and information presented in HerzFit, while negative feedback mostly concerned wearable synchronization. Conclusions The present study demonstrates the user-centered development of a guideline-based mHealth app for CVD prevention. Beta-testing and a preliminary usability study were used to further improve the HerzFit app until its official release.
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Affiliation(s)
- Lara Marie Reimer
- School for Computation, Information and Technology, Technical University Munich, Munich, Germany
- Institute for Digital Medicine, University Hospital Bonn, Bonn, Germany
| | - Leon Nissen
- Institute for Digital Medicine, University Hospital Bonn, Bonn, Germany
| | - Moritz von Scheidt
- Department of Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
- German Center for Cardiovascular Disease (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Benedikt Perl
- Department of Sport and Health Sciences, Technical University Munich, Munich, Germany
| | - Jens Wiehler
- BioM Biotech Cluster Development GmbH – BioM, Planegg, Germany
| | - Sinann Al Najem
- Deutsche Herzstiftung e.V. (German Heart Foundation), Frankfurt, Germany
| | - Florian P. Limbourg
- Vascular Medicine Research, Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany
- Deutsche Hochdruckliga e.V. (German Hypertension League), Heidelberg, Germany
| | - Theodora Tacke
- Institute of General Practice, Goethe University Frankfurt, Frankfurt, Germany
| | - Angelina Müller
- Institute of General Practice, Goethe University Frankfurt, Frankfurt, Germany
| | - Stephan Jonas
- Institute for Digital Medicine, University Hospital Bonn, Bonn, Germany
| | - Heribert Schunkert
- Department of Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
- German Center for Cardiovascular Disease (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
- Deutsche Herzstiftung e.V. (German Heart Foundation), Frankfurt, Germany
- Medical Graduate Center, Technical University Munich, Munich, Germany
| | - Fabian Starnecker
- Department of Cardiology, German Heart Center Munich, Technical University Munich, Munich, Germany
- German Center for Cardiovascular Disease (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
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Singh B, Hazra P, Roy S, Garg R, Bhat S, Patki N, Gharat C, Patel K, Tandel J. Exploring the Need and Benefits of Digital Therapeutics (DTx) for the Management of Heart Failure in India. Cureus 2023; 15:e49628. [PMID: 38161874 PMCID: PMC10755686 DOI: 10.7759/cureus.49628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
Indian heart failure (HF) registries consistently indicate high hospital readmissions and increased mortality rates after HF diagnosis. The challenges of Indian cardiologists in HF management include limited longitudinal data, frequent readmissions, low medication adherence, inadequate monitoring and follow-up, insufficient patient education, and lack of standard guidelines on cardiac rehabilitation. This article outlines the adoption of digital therapeutics (DTx) in HF management as a potential solution to address these challenges. DTx services offer improved medication adherence, early symptom identification, remote vital monitoring, timely intervention, patient education on symptoms, self-awareness, and lifestyle. Overall, DTx for HF comprises a dedicated team of cardiologists, health coaches, care managers, and globally certified connected devices to provide comprehensive and proactive monitoring, personalized coaching and support, behavioral engagement to improve adherence, emergency response system, delivery of medications and diagnostic tests at home, and a dedicated application for caregivers. DTx has the potential to enhance HF management in India.
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Affiliation(s)
- Balbir Singh
- Cardiology, Max Super Speciality Hospital, Saket, Delhi, IND
| | - Prakash Hazra
- Cardiology, Advanced Medicare and Research Institute (AMRI) Hospitals, Kolkata, IND
| | - Sanjeeb Roy
- Cardiology, ManglamPlus Medicity, Jaipur, IND
| | - Rajeev Garg
- Cardiology, Aware Gleneagles Global Hospitals, Hyderabad, IND
| | - Sanjay Bhat
- Cardiology, Aster CMI Hospital, Bengaluru, IND
| | | | - Chetan Gharat
- Medical Affairs, Lupin Digital Health Limited, Mumbai, IND
| | - Kamlesh Patel
- Medical Affairs, Lupin Digital Health Limited, Mumbai, IND
| | - Jeeten Tandel
- Medical Affairs, Lupin Digital Health Limited, Mumbai, IND
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