Division of Cardiovascular Medicine, Department of Medicine, Stanford University, 870 Quarry Road, Stanford, CA, 94305, USA.
Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA.
Heart Fail Rev. 2024 Nov;29(6):1239-1245. doi: 10.1007/s10741-024-10433-7. Epub 2024 Sep 6.
The clinical and economic impact of heart failure (HF) is immense and will continue to rise due to the increasing prevalence of the disease. Despite the availability of guideline-recommended medications that improve mortality, reduce hospitalizations, and enhance quality of life, there are major gaps in the implementation of such care. Quality improvement interventions have generally focused on clinicians. While certain interventions have had modest success in improving the use of heart failure medications, they remain insufficient in optimizing HF care. Here, we discuss how patient-facing interventions can add value and supplement clinician-centered interventions. We discuss how digital health can be leveraged to create patient activation tools that create a larger, sustainable impact. Small studies have suggested the promise of digital tools for patient engagement and self-care, but there are also important barriers to the adoption of such interventions that we describe. We share key principles and strategies around the design and implementation of digital health innovations to maximize patient participation and engagement. By uniquely activating patients in their own care, digital health can unlock the full potential of both existing and new quality improvement initiatives to drive forward high-quality and equitable heart failure care.
心力衰竭（HF）的临床和经济影响巨大，并且由于疾病的患病率不断上升，这种影响还将继续增加。尽管有改善死亡率、减少住院次数和提高生活质量的指南推荐药物，但在实施此类治疗方面仍存在重大差距。质量改进干预措施通常侧重于临床医生。虽然某些干预措施在改善心力衰竭药物的使用方面取得了一定的成功，但仍不足以优化心力衰竭的治疗。在这里，我们讨论了面向患者的干预措施如何增加价值并补充以临床医生为中心的干预措施。我们讨论了如何利用数字健康来创建患者激活工具，以产生更大、更可持续的影响。小型研究表明，数字工具在患者参与和自我护理方面具有很大的潜力，但我们也描述了采用此类干预措施存在的重要障碍。我们分享了数字健康创新的设计和实施方面的关键原则和策略，以最大限度地提高患者的参与度。通过独特地激活患者自身的护理，数字健康可以释放现有和新的质量改进计划的全部潜力，推动高质量和公平的心力衰竭护理向前发展。
