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

Abstract

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.