Assessing Organisational Readiness for Heart Failure Remote Monitoring
Research type
Research Study
Full title
A Systematic and Evidence-based Approach to Assessment of NHS Organisational Readiness to Commence Haemodynamic Remote Monitoring through Cardiac Implantable Electronic Devices (CIEDs) in Routine Heart Failure Care. (SEARCH-HF)
IRAS ID
236418
Contact name
Martin R Cowie
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Patients with heart failure (HF) episodically present with worsening symptoms of breathlessness and fluid build-up which often require hospitalisation to treat. Whilst the HF patient may only be more symptomatic in the few days before deterioration, the underlying process of fluid build-up can take several weeks, going unnoticed beforehand. Cardiovascular implantable electronic devices (CIEDs), such as pacemakers and defibrillators, are part of standard therapy in the management of HF patients. These devices can additionally be set up to provide monitoring of the patient’s clinical status, with the results remotely transmitted to the clinical team, allowing earlier recognition of deterioration and allowing an opportunity to change treatment to minimise symptoms and avert hospital admission. \nThere have been mixed results with these remote heart failure monitoring systems. Some trials have shown an improvement in survival and a reduction in hospital visits, whilst other studies have shown no benefit. It is likely this is due to the context within which the systems were used – experienced centres with the necessary infrastructure (technology, staffing, patient pathways) will do better than settings where no structure exists.\nThe aim of this project is to develop a model care pathway and assessment tool to help NHS centres begin, or improve, remote monitoring in heart failure. We will undertake a systematic appraisal of what is needed to launch a remote monitoring (RM) service, by reviewing the published literature and gaining insights from patients and staff who have experience with HF RM. The model pathway, and an assessment matrix tool, will allow a rapid evaluation of what infrastructure, education or training is needed for an institution looking to commence a programme of RM. We will validate the utility of this pathway and assessment tool by taking feedback from the institutions that have introduced remote monitoring into their routine heart failure care using our framework.\nFinally, using insights from our systematic appraisal we will pilot the development of resources to deliver the necessary education for both patients undergoing, and staff undertaking, remote monitoring in heart failure.
REC name
North of Scotland Research Ethics Committee 2
REC reference
17/NS/0126
Date of REC Opinion
8 Jan 2018
REC opinion
Further Information Favourable Opinion