Abstract 11804: Implementing a Digitally-Enabled Community Health Worker Intervention for Patients With Heart Failure: A Randomized Controlled Trial

Abstract

Introduction: Heart failure (HF) readmissions are a leading cause of US 30-day hospital readmissions. Factors related to clinical complexity and unmet social needs are among the key drivers associated with HF negative clinical outcomes. Digital platforms have shown promise in improving HF outcomes but limitations like patient lack of familiarity with technology and unmet social needs continue to limit implementation and adoption. Hypothesis: An intervention pairing HF patients with a digital platform and a community health worker (CHW) for 30 days post-hospital discharge is (a) feasible, (b) acceptable, and (c) can demonstrate preliminary effectiveness in reducing 30-day hospital readmissions, emergency department (ED) visits, and missed clinic appointments compared to control (CHW only). Methods: Participants (n=50; enrolled 9/2022-6/2023) were randomized to intervention (CHW + digital platform) or control (CHW only). Intervention participants received a digital platform within a mobile phone application (daily symptoms questionnaire, educational videos) connected to a biometric sensor (tracking heart rate, oxygenation, steps taken), a digital weight scale, and a digital blood pressure monitor. Feasibility (use of the platform and engagement with the CHW), acceptability (willingness to use the intervention again), and clinical outcomes (30-day readmissions, ED visits, and missed appointments) were tracked. Results: As of June 1, 2023 (n=42), preliminary analysis demonstrates intervention feasibility (participant use of the sensor (avr 11.1 hrs/day), digital blood pressure (1.3 times/day; SD=0.22) and weight scale (1.1 times/day (SD=0.18) on 81-86% of study days; symptom questionnaire completion on 75% of study days; >3 CHW interactions occurred for 71% of participants) and acceptability (84% of participants indicated willingness to use the intervention again). Clinical outcome data analysis completion is forthcoming September 2023. Conclusions: A novel intervention combining a digital platform with CHW social needs care in HF was feasible and acceptable. Clinical outcome data analysis completion is forthcoming September 2023. A larger future clinical trial is needed to determine the intervention’s true effectiveness.