Remote Patient Monitoring for Patients with Heart Failure: Sex- and Race-based Disparities and Opportunities

• Type of Material: Article
• Authors: Ioannis Mastoris, Massachusetts General Hospital; Ersilia DeFilippis, Columbia University Irving Medical Center; Trejeeve Martyn, Kaufman Center for Heart Failure Treatment and Recovery, Cleveland Clinic; Alanna Morris, Emory University; Harriette GV Spall, McMaster University; Andrew J Sauer, University of Missouri-Kansas City
• Language: English
• Date: 2023-01-01
• Publisher: Radcliffe Cardiology
• Publication Version: Final Published Version
• Copyright Statement: © 2023, Radcliffe Cardiology
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.15420/cfr.2022.22
• Title of Journal or Parent Work: Cardiac Failure Review
• Volume: 9
• Keywords: Remote Patient Monitoring; heart failure; health equity; racial disparity; sex difference
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Remote patient monitoring (RPM), within the larger context of telehealth expansion, has been established as an effective and safe means of care for patients with heart failure (HF) during the recent pandemic. Of the demographic groups, female patients and black patients are underenrolled relative to disease distribution in clinical trials and are under-referred for RPM, including remote haemodynamic monitoring, cardiac implantable electronic devices (CIEDs), wearables and telehealth interventions. The sex- and race-based disparities are multifactorial: stringent clinical trial inclusion criteria, distrust of the medical establishment, poor access to healthcare, socioeconomic inequities, and lack of diversity in clinical trial leadership. Notwithstanding addressing the above factors, RPM has the unique potential to reduce disparities through a combination of implicit bias mitigation and earlier detection and intervention for HF disease progression in disadvantaged groups. This review describes the uptake of remote haemodynamic monitoring, CIEDs and telehealth in female patients and black patients with HF, and discusses aetiologies that may contribute to inequities and strategies to promote health equity