Remote monitoring of heart attack patients significantly reduced hospital readmissions
Remote monitoring of patients who had recently had a heart attack was found to have a significant effect on readmissions to hospital, in research carried out at Imperial College London with patients at Imperial College Healthcare NHS Trust.
The research study, funded by the British Heart Foundation (BHF), involved 337 patients who came to Hammersmith Hospital with acute coronary syndromes (ACS) over 15 months and were considered to be at high risk of a second heart attack. Acute coronary syndromes are a group of life-threatening conditions that involve reduced blood flow to the heart, including heart attacks and unstable angina – a more severe form of angina which can happen at rest and doesn’t improve with rest or medicines.
Half of the group had devices installed at home, allowing them to send their vital signs and call specialist cardiology teams for a remote consultation – known as ‘telemedicine’ - when they experienced worrying symptoms. The other group of patients followed normal care pathways, taking medicine and consulting their GPs or attending hospital if they had cause for concern.
In the study, telemedicine patients were 76 per cent less likely to be readmitted to hospital within six months and 41 per cent less likely to attend A&E, compared to those who followed normal care pathways. Researchers suggest that remote monitoring could help to tackle pressure on health systems worldwide.
The study was presented at the American College of Cardiology (ACC) conference in Atlanta and published in the Journal of the American College of Cardiology. It received funding from Imperial Health Charity.
The group of telemedicine patients also had a 15 per cent lower risk of repeat heart attacks after nine months, and a lower number of unplanned surgical procedures on the blood vessels of the heart. The rate of strokes was also lower in the telemedicine group.
In the UK, around 100,000 hospital admissions a year are due to a heart attack. Around 15 per cent of patients admitted to hospital for a heart attack in England are readmitted as an emergency within 30 days of being discharged.
Using telemedicine allowed cardiologists to assess patients before they came to hospital to judge whether A&E attendance was necessary. Even for those who were readmitted to hospital, the average length of stay was half a day – much less than the average one and a half days in the standard care group.
Data also showed that telemedicine patients were less likely to report symptoms including chest pain, dizziness and shortness of breath.
Dr Ramzi Khamis,consultant cardiologist at Imperial College Healthcare NHS Trust and BHF research fellow at the National Heart and Lung Institute, Imperial College London said: “The approach we designed and tested is focused on sparing valuable time and resources while providing a well-informed treatment plan for high-risk patients experiencing worrying symptoms. The study clearly showed that sending vital information straight to cardiology teams, coupled with a consultation, led to seemingly better care, reductions in admissions, average length of stay and A&E attendance.”
“This simple strategy could potentially free up thousands of hospital beds and doctors’ hours across the country whilst keeping patients just as safe. We are now looking at working with the NHS and other healthcare systems globally to adopt this strategy and hopefully improve treatment for future patients.”
Professor James Leiper, Associate Medical Director at the BHF, said: “The results of this study are very encouraging and have the potential to relieve some of the current pressure on the NHS as hundreds of thousands of people wait for urgent heart tests, treatments and check-ups. The findings suggest that telemedicine may have a significant role to play in freeing time and space in hospitals, whilst maintaining safety and even improving outcomes for at-risk patients.
“It is important that the NHS has enough trained and supported staff to deliver on this approach, and the tools to identify and target the right patients. Telemedicine could prove to be a valuable tool for clinicians to bring real improvements for patients during a difficult time in their lives.”
Research at Imperial College Healthcare is supported by funding from the National Institute for Health and Care Research (NIHR) Imperial Biomedical Research Centre (BRC), a translational research partnership between Imperial College Healthcare NHS Trust and Imperial College London, which was awarded £95m in 2022 to continue developing new experimental treatments and diagnostics for patients.
