Opinion: New technology can improve patient results after heart failure
Heart failure is becoming more and more common. Nearly 6 million Americans are suffering from it today. That figure will grow to more than 8 million by 2030.
The condition exerts an enormous toll on Michigan's patients, their families, and the economy. Fortunately, advances in medical research have yielded new technology that can help Michiganders with heart failure live healthier, fuller lives -- and reduce overall healthcare costs. It's time to fully deploy that technology.
Heart failure occurs when a person's heart struggles to pump blood. This deprives the body of oxygen and nutrients, which can make performing even basic daily activities -- like walking or climbing the stairs -- difficult.
Heart failure is rampant problem here in Michigan. The condition is responsible for 190 deaths per 100,000 people. And it hospitalizes 45 of every 1000 Medicare beneficiaries. In 2010, Michigan spent more than $10 billion on medical costs related to heart disease, according to a report by the Michigan Department of Health & Human Services.
On a national scale, heart failure hospitalizes more than 1 million Americans every year. About half are back in the hospital within six months of diagnosis; the average stay lasts five days. That's a huge burden for patients -- and for caregivers, who may not live nearby and thus may have to miss work. In total, the condition costs the U.S. more than $30 billion every year.
The standard treatment regimen for heart failure -- take medication, reduce salt intake, and stay active -- has been in place for many years. But it has never been truly effective, largely because it's complicated and difficult for patients to follow.
Consider medication. Some drugs do help patients. But three-quarters of patients don't consistently take their medications as instructed. More than one in four never fill a new prescription. And doctors sometimes don't prescribe all the medication that's recommended.
Advising patients to eat less sodium is ineffective, too. Do you know how much sodium you consume? Neither do patients. Ninety-seven percent of Americans underestimate -- or don't feel confident estimating -- the amount of sodium they eat each day, according to the American Heart Association.
And when it comes to exercise, many patients don't have the time, resources, or social support to get in daily recommended workouts. In Michigan, less than a quarter of people report getting the amount of exercise recommended by the 2008 federal guidelines.
In other words, the status quo for treatment of heart failure isn't working. But medical researchers are working to change that by developing technologies that can help physicians more effectively monitor and treat heart failure -- and improve patients' quality of life.
Consider one device that measures the heart activity of cardiac patients during rehabilitation training. The smartphone-sized unit helps ensure that workouts are at a safe intensity level and duration. Clinicians can immediately determine if a patient's heart rate is becoming too fast or irregular. The device is demonstrated to improve the health and recovery of heart failure patients.
Researchers at Harvard University are toying with a wearable device that can monitor ankle swelling -- a common symptom of worsening heart failure. That could help ensure patients seek medical attention before a major problem occurs.
Or consider an innovation I helped develop at Abbott. The CardioMEMS HF system enables doctors to proactively monitor patients' pulmonary artery pressure and heart rate remotely. So clinicians can detect worsening heart failure before a patient even feels symptoms and adjust medications accordingly. That helps keep patients out of the hospital.
Indeed, research published in the Journal of the American College of Cardiology last year showed that hospitalizations for heart failure declined 46 percent in patients six months after receiving the device. Based on Medicare claims data, average healthcare costs per patient were $10,500 lower than in the six months before the implant.
Traditional treatment for heart failure is, itself, failing. We can achieve far greater success -- for Michiganders living with the disease, for our health system, and for our society -- by embracing new technology that can better monitor and treat heart failure.
Philip B. Adamson, M.D., is a cardiologist, heart failure specialist and medical director at Abbott.