Improvement of the heart failure patient process for the prevention of new events through tele-education and continuous tele-optimization of the treatment by nursing staff

Perez Serrano, M; Carlos Nicolas Perez Garcia, CNP; Daniel Enriquez Vazquez, DEV; Marcos Ferrandez Escarabajal, MFE; Jesus Diz Diaz, JDD; Noemi Ramos Lopez, NRL; Isidre Vila Costa, IVC; Mariam Bas Villalobos, MBV; Christian Bengoa Terrero, CBT; Alejandra Restrepo Cordoba, ARC; David Vivas Balcones, DVB; Josebe Goirigolzarri Artaza, JGA; Ramon Bover Freire, RBF; Carlos Macaya Miguel, CMM

FUNDING ACKNOWLEDGEMENTS: Type of funding sources: None. INTRODUCTION: patients with heart failure (HF) are especially vulnerable to SAR-CoV-2 infection especially due to their worse prognosis for this disease. PURPOSE: to demonstrate that patients with HF will present similar health outcomes if their education and pharmacological treatment is optimised remotely by a nurse rather than through conventional care. METHODS: A single-centre, observational, prospective, non-randomized study was carried out in which two groups were compared. The experimental group had most of their care provided virtually by a nurse who could optimise their medication according to the clinical guides whilst the control group received conventional face-to-face care. During a follow-up period of 6 months, patients included in the study have an initial face-to-face consultation with a cardiologist and an evaluation of the patient where the treatment objectives are established. The rest of the follow-ups were done through videoconsultation with the nurse every 15 days for 6 months where the neurohormonal treatment was optimized and an educational program was carried out with different cardiovascular educational topics. RESULTS: Thirty-seven patients have been included. Sex: 30 men (81.0%) and 7 women (19.0%) Mean age: 67.9 years (12.8). Range 42-87 years. Etiology: 61.2% ischemic and 38.8% non-ischemic mean LVEF at inclusion = 30.2%. A total of 17 patients have completed the study: a 13% average improvement of FEVI, a reduction of NT-proBNP of and improvement in functional heart failure class. The primary objective was to compare the proportion of neurohormonal drugs prescribed, as well as the mean of the maximum doses reached in each after 6 months of follow-up, as well as mean ejection fraction, NYHA class and mean NT-proBNP (Table 1) CONCLUSIONS: Telemedicine offers us valuable tools that allow us to take care of chronic patients, reducing exposure to the virus as much as possible. Efficient use of virtual tools and human resources makes close monitoring possible. Specialized nursing is a key element in the education, pharmacological optimization and monitoring of these patients.