For many Americans with heart failure, getting the right medications and doses can be a slow process, often leading to delays in treatment and increased health risks. A recent study led by Duke Health suggests that remote digital care may help address these challenges.
The research was presented at the Heart Failure Society of America’s Annual Scientific Meeting. It highlights that nearly half of U.S. counties lack a cardiologist, which limits access to specialized heart care for many patients.
“We need scalable tools to reach people where they are,” said Adam DeVore, M.D., associate professor in the Department of Medicine at the Duke University School of Medicine and lead author of the study. “If you look across the roughly 3,100 counties in the United States, 46% don’t have a cardiologist.”
“People who live in areas without that access experience more heart disease and are more likely to die from heart problems,” DeVore added. “Add to that, appointments for medication titration are a real challenge in heart failure care. There are a lot of real-world barriers that make it really difficult.”
The study was funded by Innovaccer Inc., which developed Story Health—the digital platform tested in this trial.
Researchers found that patients using the remote program for managing their heart failure medications experienced greater improvements compared to those receiving standard care. There was no increase in hospitalizations or emergency visits among those using the digital system.
The clinical trial enrolled 178 patients across seven U.S. health systems and was coordinated by the Duke Heart Center. Participants used connected devices like blood pressure cuffs and scales to track their daily health data via mobile devices.
This information was sent securely to clinicians through the digital platform, which also offered personalized medication recommendations. Health coaches assisted patients with tasks such as arranging lab tests and pharmacy pickups, reducing the need for frequent office visits.
The program improved use of all four main therapies for heart failure—patients were more likely to reach target doses of important drugs (beta-blockers, ARNI, MRA, and SGLT2 inhibitors).
“A remote platform offers a scalable option for both clinicians and health systems to try to improve the care we’re already providing to patients with heart failure,” DeVore said.
“If we can get people on the right doses and the right number of medicines sooner,” he continued, “they have the possibility of living longer and staying out of the hospital more.”
Other authors on this study include Cynthia L. Green, Nancy M. Albert, Amir R. Haghighat, Sunit-Preet Chaudhry, Hirak Shah, Mosi K. Bennett, Tom Stanis, Ashul Govil, Trejeeve Martyn, Jaime McDermott, Mirza S. Khan, and Andrew J. Sauer.
Duke University Hospital is located in Durham, North Carolina; it was founded in 1925 and admitted over 41,000 patients during 2022 according to its annual report.
https://www.dukehealth.org/hospitals/duke-university-hospital
