Overall, after 90 days, MMS users were associated with fewer emergency room (ER) visits (12.6% vs. 27.3%), hospital readmissions (8.8% vs. 16%), minor complications (12.2% vs. 20.7%) and major complications that required intervention (8.8% vs. 16%). The most common reasons patients had to visit the ER were heart failure symptoms, neurological symptoms and syncope/falls. Common complications included conduction block requiring a pacemaker, pulmonary issues, urinary tract infections and acute kidney injuries.
“We demonstrated a 7.2% reduction in readmissions, a 14.7% reduction in ER visits, and a 15.7% reduction in total complications among patients using the digital health app,” the authors wrote. “These percentages represent numbers needed to treat (NNT) of 14, 7, and 7, respectively. When adjusted for age, sex, insurance status, STS score, and prior valve replacement status, the odds ratios for all of these outcomes remain statistically significant, suggesting that app use is associated with improved outcomes across demographics and severity of preoperative comorbidities.”
The group noted that MMS is “one of the first” health apps of its kind that has been proven to improve outcomes after cardiac surgery.
“Although it is not possible to prove direct causality, our results represent a robust analysis, and given the low-risk, low-cost nature of presenting a patient with a smartphone application, implementing digital health tools should be prioritized in procedural settings such as TAVR,” the authors added. “The utility of digital health seems to stem from its ability to increase patient engagement, which is a known factor in improving patient outcomes.”
The authors did note that this is only a single-center study, which represents a significant limitation. However, they do think these results are “generalizable to the wider population of patients undergoing TAVR.”
Click here to read the full study in the Journal of Invasive Cardiology.