A multidisciplinary out-patient clinic for frailty assessment in patients with hert failure will be established including functional and psychological disability monitoring. Nurses will be trained as case managers and the study protocol will be conceived addressing ethical and legal issues. Upon hospital discharge for acute heart failure, older adults and their caregivers will be enrolled in the study, stratified by multidimensional frailty, assigned to personalized care plans with an e-health platform for multiparametric monitoring and point of care instrumental and biochemical data collection. Heart failure patients will be managed accordig to current PDTA-based standard care.
Brief description of the activities and of the intermediate results
Case manager and nurses training is complete. The multidisciplinary team is considering the use of POCT (Point Of Care Testing) to assess biochemical markers during the study. For regular frailty status assessment the realization of a web application to be integrated in our e-health platform for patient management is underway. While waiting for ethical committee approval of the study protocol, multidisciplinary team is contacting possible candidate patients and caregivers (dyads) to explore eligibility criteria and willingness to participate to the study.
Main policy, industrial and scientific implications
A tight collaboration between the research multidisciplinary team and web applications manufactures is ongoing to set-up frailty assessment e-tool.
A partially functional prototype of the web app for frailty status assessment for dyads to be integrated in our e-health platform for patient management is currently under evaluation. More specifically the web app is based on scientific evidences coming from previous studies. While waiting for ethical committee approval of the study protocol, multidisciplinary team is contacting possible candidate patients and caregivers (dyads) to explore eligibility criteria and willingness to participate to the study.
The e-health based patients and caregiver management platform has almost been completed and coupled with the available wearable monitoring devices. Although not completed, the platform's core functions have been showed in the meeting held in Termoli (CB) on the 12 of september. Moreover, in the same meeting, results of a preliminary cross sectional analysis of dyads willing to partecipate the study has been presented.
Technical tuning of multiparametric monitoring devices. In particular, Electrocardiographic and thoracic impedance traces are currently being tested in comparison to gold standard devices. Devices-platform coupling is being updated accordingly.
Live on-patient tuning of multiparametric devices and platform-device coupling. Given the availability of device’s technical and safety data, experimental protocol has been submitted to the institutional ethical committee. Operational tuning of multidimensional frailty assessment app.
Final live testing of devices performance and device-platform coupling and performance. Live operational tuning of multidimensional frailty assessment app. Experimental protocol approval from the institutional ethical committee without amendments and recommendations. Patients selection and enrollment according to ethical committee approved protocol.
Experimental study ongoing.